State of GEORGIA resident CAN ENROLL ONLINE OR OVER THE PHONE IN A ORIGINAL MEDICARE INSURANCE HEALTH PLAN.
Are you looking to compare your medicare health insurance option or maybe you are planning to apply for a medicare advantage plan for Georgia resident?
O’Neal Insurance Group offers professional guidance at no cost to you.
Helping to ensure you, that the coverage you choose is the best original or medicare advantage plan to meet your healthcare needs.
A Glimpse of the Original Medicare Health Insurance in Georgia
Original Medicare is the primary health insurance coverage for a beneficiary who are new or current members and some disabled residents of Georgia.
This is a federal government -approved health plan that offers multiple types of medical coverage and resources to people in need.
By 2018, there were more than 1.6 million beneficiaries enrolled in the Georgian Medicare programs.
The numbers continue to grow and are predicted to multiply in the coming years.
Here are a few insightful trends associated with this state’s Medicare plans:
Medicare Advantage Plans (Part C) is fully accessible throughout the state. This means that this type of program is available to every eligible resident of Georgia regardless of their service area.
There are 71 Medicare Advantage Plans and 24 standalone Medicare Prescription Drug Plans available in the state, depending on the beneficiary’s location.
The majority of Georgians opt for the Original Medicare Health Plan (Part A & B) instead of supplementary health plans.
On the whole, Medicare seems like the first choice for citizens over 65 in Georgia. The plan gives them a chance to receive affordable healthcare at this point in life with minimum issues. They are, however, still skeptical about Medicare Advantage Plans and supplementary coverage.
We wish to remove this confusion by breaking down the core components of each program. That way, you can apply for a health plan that adds greater value to your life.
ORIGINAL MEDICARE HEALTH INSURANCE IN GEORGIA:
Which One Is Right For You?
Get your hands on the best Medicare health plan in the state.
Whether you’re turning 65 or are eligible for medical coverage due to a disability, you should brush up your knowledge about the federally approved insurance available in Georgia. The right information can allow you to maximize your coverage and decrease out-of-pocket expenditures when it comes to healthcare.
Here’s a sneak peek at what each healthcare plan entails for the beneficiary:
Original Medicare Plan (Part A)
Also known as the ‘hospital insurance’ part of the Original Medicare scheme, this plan covers general hospital services. These include services (e.g. meals and nurse care) and supplies (e.g., medication) required during hospital care, along with inpatient care, skilled nursing facility, and sometimes a hospice setup. Some plans also cover home health care services for critical cases. However, you must note that the covered services might come with individual costs (e.g. copayments, coinsurance, and deductibles).
Original Medicare Plan (Part B)
Part B is the ‘medical insurance’ part of the Original Medicare Healthcare Plan. This plan covers medical expenses required when you’re not in the hospital. The services include lab tests, ambulance services, and visits to the doctor, special medical supplies, and therapy sessions (e.g. chemotherapy). The coverage might consist of home health care services in specific scenarios. Part A and B are generally taken together to receive hospital and medical insurance. The plans are often limiting―for some patients―because they don’t cover prescriptions, custodial care, and basic checkups (e.g. eye, dental, and hearing exams).
Medicare Advantage Plan (Part C)
This type of Medicare health insurance is authorized with private insurance firms that are selected by Medicare. It’s an alternative health plan that covers benefits from the Original Medicare Plans (Part A and Part B) along with additional privileges. These include routine checkups (e.g. vision, dental, and hearing), prescription drugs, and health wellness, classes.
Medigap (Medicare Supplement)
The complementary health plan covers out-of-pocket expenses and additional medical costs that aren’t included in the standard Medicare Health Plans. This includes coinsurance, copayments, and, deductibles, along with other benefits.
Medicare Prescription Drug Plan (Part D)
Most Medicare Health Plans are limited to medication received in the hospital setup. If you want coverage for prolonged treatments via prescriptions, then you have to apply for Medicare Part D. The plan provides you coverage for prescriptions authorized by your healthcare provider. The list of drugs in the plan varies from one service area to another.
Beneficiaries can enroll in a standalone program that aligns with their Original Medicare Health Plan. You can also use it as an extension of your Medicare Advantage Plan.
On the whole, Medicare Health Plans covers different aspects of your treatment and routine medical checkups. The trick is to enroll in a plan that addresses your specific medical requirements and minimizes your expenses.
Eligibility Requirements For Georgia
Who Can Qualify for Medicare Health Plans in Georgia?
Like most Medicare Health Plans, the one in Georgia is available to every U.S citizen in the state. The accessibility is extended to all legal permanent residents in the state, who have spent at least 5 years in the country after becoming receiving residency.
Apart from this, each beneficiary must meet these standards:
You are 65 years old and can qualify for social security. Individuals who already have social security are enrolled in the Original Medicare Plan (Part A & B) automatically.
Part A is free of cost for citizens who have paid Medicare taxes for the past ten years.
Residents who have a prolonged disability can qualify for the healthcare plans before they turn 65. They should, however, receive Social Security Disability for a minimum of 2 years before enrollment.
Moreover, eligibility for Part C and Part is the same. You simply have to apply for these health plans after enrolling for the Original Medicare Health Plan. Also, ensure that your plan and desired services are available in your zip code.
Otherwise, you won’t receive the required benefits on your current health plan.
Hint: Medicare disability is any type of permanent physical and mental impairment that requires continuous treatment.
Medicare Advantage Plans: A Closer Look
Maximize your medical coverage with the right advantage plan.
As mentioned before, Medicare offers advantages and supplemental insurance plans for anyone who wants extra coverage. These plans include the standard medical benefits along with other perks (e.g. routine appointments). This type of coverage is authorized by private insurance companies that are in collaboration with Medicare.
With that said, you will have to pay individual deductibles, coinsurance, and copayments for these types of health plans. The good news is that their premium is lower than the Original Medicare Plans.
Let’s look at the most common type of Medicare Advantage Plans in Georgia:
1. Health Maintenance Organization (HMO)
The health plan provides beneficiaries with a network of doctors and healthcare facilities that are associated with the insurance company. The enrollees are required to use their services if they want discounted rates and insure medical services.
Due to their rigid guidelines, you can only use the healthcare providers within the network for treatment. You also need a referral from your primary care provider if you’re consulting a specialist. Also, beneficiaries who visit alternative hospitals will have to pay the full fee.
2. Preferred Provider Organization (PPO)
Unlike the previous health plan, the PPO offers more flexibility to its beneficiaries. You have the right to receive treatment from the chosen network of healthcare providers, along with external facilities. The only condition is that out-of-network treatments require you to pay additional out-of-pocket costs.
Want more options?
Then you can opt for the Private Fee-for-Service (PFFS) plan that provides you with the freedom to choose your healthcare provider. The provider must, however, adhere to the insurance guidelines if you want the insurance company to pay for your treatment.
Residents of Georgia with chronic conditions and disabilities can choose the Special Needs Plan (SNP). It’s a hybrid plan for beneficiaries that require specific medical services from their health insurance.
When Should You Apply For Medicare In Georgia?
You get three chances to enroll in the Medicare Health Plan.
Residents of Georgia have multiple opportunities to send their applications for healthcare insurance. If you receive Social Security, then your enrollment to this health plan is automatic. If that isn’t the case, then you should contact Social Security headquarters in your state to apply for both benefits.
Moreover, some employers also include Part A in their health plans for elderly employees.
The three enrollment periods to sign up for Medicare are as follows:
This is a 7-month long period that begins three months before your 65th birthday. Example: If you turn 65 in April 2020, then you can send your application from January to July 2020.
Beneficiaries who couldn’t sign up during the initial enrollment because of spousal health insurance or employee-based group coverage receive a special enrollment date after the previous coverage expires. This period lasts for 8 months after your coverage ends.
Eligible residents can participate in the annual Medicare sign up period that runs from January to March every year. The beneficiaries will receive coverage from July 1 in the same year.
Disclaimer: Residents who don’t sign up for Part B during their initial enrollment may have to pay a penalty of 10% premium according to their delay. This penalty generally lasts throughout the Medicare coverage.
How Can We Help?
Enrolling in the right health plan isn’t as easy as it seems. The team from O’Neal Insurance Group can provide you with professional insights and resources. That way, you can select the best Original Medicare Health Plan in Georgia.
Our services include a free consultation, evaluation, and other resources. The best part is that we don’t charge anything for the consultation sessions.
Are you ready to enroll in a Medicare Health Plan?
Book a free consultation to make the best decision.