For most covered services, Original MedicareOriginal Medicare is a fee-for-service health insurance program available to Americans aged 65 and older and some individuals with disabilities. Original Medicare is provided by the federal government and is made up of two parts: Part A (hospital insurance) and Part B (medical insurance). pays 80% of the bill, and you pay the rest.
Medicare Supplement Plans can help cover out-of-pocket costs such as deductibles, copayments and coinsurance.
There are 12 Medigap plans available in Georgia, including two high-deductible plans.
The cost of Medigap plans depends on the type of plan, when you enroll, where you live and more.
More than 1 million Georgians have Original Medicare coverage. Original Medicare includes Part A (hospital coverage) and Part B (medical coverage). But Original Medicare in Georgia doesn’t cover your entire bill. Instead, Medicare pays 80% of most covered services, and you pay the remaining 20%.
Medicare Supplement Plans, or Medigap plans, can help you fill in this “gap” in coverage. These plans can cover your deductibles, copayments and coinsurance to lower your out-of-pocket costs associated with Original Medicare.
There are 12 Medigap plans offered in Georgia, so you have a lot of coverage options. Georgia Medigap policies include Plans A, B, C, D, F, G, K, L, M and N. Do you have a Medigap plan not listed here? Plans E, H, I, and J are no longer for sale, but if you enrolled in one of these plans before June 1, 2010, your coverage may still apply.
All Medigap plans in Georgia will cover:
- Medicare Part A coinsurance for hospital and hospice care
- Medicare Part B coinsurance and copayments
- Blood (first 3 pints in a year)
Some Medigap plans in Georgia will also cover:
- Part A deductible
- Part A coinsurance for skilled nursing care facility
- Part B excess charges
- Foreign travel emergency health care services or supplies
For more information about what’s included in each Medigap plan, use this side-by-side comparison chart. Compare each plan carefully as you decide which plan may be the right choice for your lifestyle, budget and healthcare needs.
Find a local Medicare plan that fits your needs
Medicare Supplement Plan costs are set by private insurance companies. While plan coverage is standardized, the cost is not. Medigap plan costs can be calculated in three ways:
- Community-rated: Everyone enrolled in the plan pays the same premium.
- Issue-age-rated: Premiums are determined by your age when you enroll in the plan.
- Attained-age-rated: Premiums are based on your current age. Premiums go up every year and can increase significantly each year.
How much is Plan G in Georgia?
Medigap Plan G is popular in Georgia because it is one of the most comprehensive plans available. Benefits include:
- 100% coverage of the Part A deductible
- 100% coverage of Part A coinsurance for hospital, hospice and skilled nursing facility care
- 100% coverage of Part B excess charges
- 100% coverage of Part B coinsurance and copayments
- 80% foreign travel medical emergency coverage, up to plan limits
Medigap Plan G premiums in Georgia can range from $113 to $3,304 in 2022. This does not include the Medicare Part B monthly premium of $170.10 for most recipients, or the Part B deductible of $233.
The Medigap Plan G high deductible plan premiums range from $40 to $2,024. Just like Medigap Plan G, the high deductible plan does not cover the Part B monthly premium or yearly deductible. This plan also includes its own deductible. You will need to pay a $2,490 yearly plan deductible before coverage starts.
Medigap Plan F also offers a high deductible plan, but this plan is only available if you became eligible for Medicare coverage before January 2020.
To buy a Medigap plan in Georgia you need to be enrolled in Medicare Part A and Part B. Once you’re enrolled in Original Medicare, you’re eligible for any Medigap plan available in your area.
You can enroll in Medigap as soon as your Original Medicare coverage begins. The best time to purchase a Medigap plan is during your Medigap Open Enrollment Period, which begins the first day you have Medicare Part B. You’ll have six months to enroll in a Medigap plan. If you miss your Medigap Open Enrollment Period, you can still buy a Medigap plan, but the insurance company may increase your premiums or reject your application based on your health status or other criteria.
Are you eligible for cost-saving Medicare subsidies?
In the past, some Medigap plans included prescription drug coverage, but Medigap plans no longer include any prescription drug coverage. You can add a Medicare Part D plan to your Original Medicare for medication coverage. Just remember that your Medigap plan doesn’t pay any out-of-pocket costs for Part D plans.
Medigap plans and Medicare Advantage plans are sometimes offered by the same private insurance companies. But these plans are very different. Medigap plans are designed to cover your Original Medicare costs so you won’t pay out-of-pocket for most covered services.
Medicare Advantage plans are standalone plans that are a popular alternative to Original Medicare. If you enroll in a Medicare Advantage plan, you’ll get all the same benefits as Original Medicare. Many plans also include prescription drug coverage and additional benefits.
You cannot have a Medigap plan and Medicare Advantage. You can only pair a Medigap plan with Original Medicare.
What extra benefits and savings do you qualify for?
During your six-month Medigap Open Enrollment Period, you have guaranteed issue rights. During this time, insurance companies must sell you a Medigap plan. They cannot deny you coverage based on a pre-existing health condition, or charge you higher premiums based on your health status.
You can drop your current Medigap plan or switch between plans at any time. But once your Medigap Open Enrollment Period is over, insurance companies may require medical underwriting, and they can deny your application or raise your premiums when you switch plans.
Before 65 Guide
Understanding health insurance before age 65, especially when considering early retirement