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Medicare and Medicare Advantage Coverage and Eligibility in Georgia

October 19, 2023

Medicare and Medicare Advantage Coverage and Eligibility in Georgia

As you near the age of 65, you’ll be hearing a lot about Medicare and your health insurance options. It can be a bit confusing, especially with so many parts of Medicare. Understanding the requirements for Medicare, as well as how to enroll is important.

Who is eligible for Medicare in Georgia? Is it free, or do you have to pay? This page will help you understand the essentials so that you can choose the Medicare plan that’s right for you.

How to Apply for Medicare in Georgia

As you near your 65th birthday, you’ll enter the first enrollment period for Medicare. It starts three months before your birthday month and lasts seven months. If you’re already receiving retirement benefits from Social Security or the Railroad Retirement Board, you’ll likely be enrolled in Medicare Part A and B automatically.

Sometimes you’ll still have to enroll manually. For instance, if you have to pay for Medicare Part A instead of receiving it premium-free, you’ll need to sign up.

There are four options to apply for Medicare in Georgia:

  • Contact your local Social Security office
  • Call 1-800-772-1213 to enroll over the phone
  • If you retired from a railroad, call the Railroad Retirement Board at 1-877-772-5772
  • Sign up for Part A online at and Part B using Form CMS-40B

You’ll want to enroll when you’re first eligible. If you wait too long, you may have to pay a late enrollment penalty.

Medicare Eligibility in Georgia

Who’s eligible for Medicare? Is there Medicare for kids in Georgia? Do you have to be 65?

Those are common questions we hear. Medicare is focused on those who are no longer in the workforce, but have worked long enough that they paid into the Medicare system for a period of time. However, you can get Medicare in other circumstances as well.

To get Medicare benefits, you must be a U.S. citizen or permanent resident who has lived in the U.S. for at least five years, along with one of the following:

  • Age 65 or older
  • Younger than 65 but disabled and receiving Social Security Disability payments or payments from the Railroad Retirement Board
  • Have end-stage renal disease (ESRD)
  • Have Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease

The only way for children under 18 to receive Medicare is if they have end-stage renal disease and need regular dialysis or have had a kidney transplant. Also, the child’s parents will need to have minimum work credits or be receiving social security benefits.

How Much is Medicare in Georgia

How much does Medicare cost? Does Georgia have free healthcare when it comes to seniors?

Medicare Part A, which is hospital insurance, is usually premium-free. In order to get Part A for free, you’ll need to have accrued enough work credits, which involves having time you worked and paid into the Medicare system. If you don’t have enough credits, you may be able to use your spouse’s credits instead.

Medicare Part B, which is medical insurance that covers doctor’s visits and preventive care, has a set monthly premium. Everyone pays the same amount unless you have a significantly higher income, in which case you may pay more. You may also pay more if you didn’t sign up for Medicare Part B on time and have to pay a late enrollment penalty.

Medicare Health Plans in Georgia

Medicare has several parts, each of which covers different services. Medicare Parts A and B together are known as Original Medicare[.

The different parts of Medicare are:

  • Medicare Part A, which is hospital insurance and covers inpatient stays and other costs
  • Medicare Part B, which is medical insurance and covers doctor’s visits, preventive care, and more
  • Medicare Part C, known as Medicare Advantage, is a full replacement for Original Medicare and may offer additional benefits
  • Medicare Part D is prescription drug coverage that can be added to Original Medicare

When you enroll for Medicare coverage, you want to make sure you choose the right plan for your needs.

Medicare Advantage in Georgia

Medicare Parts A, B, and D are standard no matter where you are in the country. However, Part C can vary. Medicare Advantage is offered by private insurers in the state of Georgia and each will have its own costs, benefits, and medical network.

Many Medicare recipients enjoy Advantage plans because they are able to get benefits Original Medicare doesn’t offer, such as vision and dental coverage. You may also get discounts on health clubs and free screenings for common ailments.

Best Medicare Advantage Plan in Georgia

How do you choose the best Medicare Advantage plan for your needs?

The first thing to consider is the medical network. While Original Medicare is accepted by doctors around the country, Medicare Advantage plans have in-network providers and out-of-network providers, like traditional insurance.

You’ll want to make sure that your preferred doctors are in the network before you sign up for an Advantage plan. If you travel a lot, make sure your Advantage plan includes out-of-network care at a reasonable price.

Next, review the monthly premiums and out-of-pocket costs. Many Medicare Advantage plans don’t cost any more than your normal Part B premium. Some have extra monthly fees. You’ll also want to review the copayments and deductibles to make sure they fit your budget.

Finally, review the benefits. Choose a plan that offers the benefits you need most at a price you can afford.

Best Medicare Supplement Plan F for Georgia Seniors

Medicare Supplement plans, also known as Medigap, are an option for seniors who want to stay with Original Medicare but need help paying for their deductibles, coinsurance and copayments. There are a variety of supplement plans available, and they have letters A — N.

Every plan with a specific letter in Georgia will be the same as other plans with that letter. If you’re looking at Plan F, the only difference between companies that offer it will be the monthly premium.

Keep in mind that as of 2020, newly-eligible Medicare enrollees cannot buy Medicare Supplement Plan F. (If you already have Plan F, you can keep it.) If you’re looking for something similar, you might consider Supplement Plan G.

Find & Compare Medicare Advantage Plans in Georgia

Choosing the right Medicare plan in Georgia for your needs can be confusing, and you might need a bit of help comparing your options. If so, we’re here for you. Talk to a licensed insurance agent or use our Medicare plan comparison tool.

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