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Medicare Supplement Plans In Georgia

If you’re worried about how much you’ll pay out of pocket with Medicare you’ll need to consider the private options available to help reduce them. These private plans are designed to help you save money when you use your Medicare benefits. One of the most popular kinds of coverage available is Medicare Supplement Insurance. In this article, we’ll review the ins and outs of Medicare Supplement plans in Georgia.

What Is Medicare Supplement Insurance?

Medicare Supplement Insurance is a private insurance coverage designed to work with Parts A and B of Original Medicare. Since Medicare doesn’t cover 100% of the cost for your services and procedures, you’re exposed to out of pocket spending. The costs that you’re exposed to include:

  • Part A deductible
  • Part A co-insurance amounts for long hospital stays, long skilled nursing stays, and hospice care
  • Part B deductible
  • Part B co-insurance (you pay 20% of the Medicare-approved costs for all Part B services and procedures once you’ve met the Part B deductible)
  • Part B excess charges (up to 15% of the Medicare-approved cost charged by some providers)
  • Paying for emergency care outside the United States

While the Part B deductible is only paid once, all of the other costs under Original Medicare can be experienced throughout the year. These costs are not capped in any way. Medicare doesn't come with an Out of Pocket Maximum (OOPM) like other forms of health insurance you likely had before Medicare. Instead, you pay the Part A and B costs throughout the year, no matter how much you’ve paid already. Medicare Supplement Insurance was created to help alleviate the impact of these costs. Since the various costs you’re expected to pay are referred to as gaps in Medicare, Medicare Supplement plans are frequently called Medigap plans.

How Do Medicare Supplement Plans Work?

Medigap plans are what’s called secondary coverage. That means they only work with a primary coverage, in this case Parts A and B of Original Medicare. Medigap plans provide no coverage on their own; they only pay benefits after the primary coverage has paid a claim. Medicare Supplement plans are standardized across 47 of the United States, including Georgia. This means that the benefits for the individual plans are the same in all 47 states. There are 11 standardized Medigap plans. They’re known by letter: A, B, C, D, F, G, K, L, M, and N. There are also high-deductible versions of Plans F and G. Since the benefits are standardized, the coverage provided by Plan K in Georgia is the same as Plan K in Montana. This makes it very easy to choose Medigap coverage: all of the standardized plans are the same, regardless of which insurance company you use.  When you use your benefits, say by visiting the doctor, you’ll give them both your red, white, and blue Original Medicare card and your Medigap plan card. Your doctor will bill Medicare; for Part B services like office visits, Medicare will pay the first 80% of the cost. Your doctor will also bill your Medigap plan the remaining 20%. Your Medigap plan will pay the amount they’re contracted to pay; in most cases, they’ll pay all of the outstanding amount. You might have a tiny remaining amount to pay; this is your responsibility. You can see the value of Medicare Supplement plans if you consider expensive treatment like chemotherapy. IV-based chemotherapy is usually covered under Part B of Original Medicare. Normally, you’d be responsible for 20% of the cost. Most Medicare Supplement plans, however, will cover all of your share of the cost, which can be a real financial savings. To give you an idea of how Medigap benefits vary between the standardized plans, let's look at what Plans A and G cover.

Medicare Supplement Plan A

Plan A is very basic; it covers the fewest number of gaps in Medicare. Medigap Plan A will cover:

  • Part A daily co-insurance for hospital stays longer than 60 days
  • Part A co-insurance for hospice benefits
  • The cost for your first 3 pints of blood
  • Part B co-insurance (it covers the 20% you’d normally have to pay)

That’s it. Plan A gives you no help with:

  • The Part A deductible
  • Part A daily co-insurance for longer skilled nursing home stays
  • The Part B deductible
  • Part B excess charges
  • Coverage outside of the U.S.

Medicare Supplement Plan G

Plan G is a much more comprehensive plan; it is, in fact, the most comprehensive plan available for most new Medicare Beneficiaries. Plan G fills in all the gaps in your Medicare coverage, with one exception: the Part B deductible. The only cost you’re likely to pay during the year is the Part B deductible; for 2022, the deductible is $233. You’ll pay that amount first, then Plan G covers all of your Medicare-approved costs for the rest of the year. Plan G also provides coverage for emergency care if you’re outside of the United States. The other standardized plans have benefits somewhere between these two. You can choose your level of coverage and control your costs by selecting the standardized plan that matches your needs.

How Can I Choose A Medigap Plan?

If you’ve decided to get Medigap coverage, you’ll need to determine the level of coverage you want. This coverage level should balance two conditions:

  • Minimizing out of pocket costs for services, and
  • Being able to comfortably afford the monthly premiums

In other words, you’ll want to make sure your basic needs are covered, but that you can afford the cost of the coverage. If you have had health struggles already in your life, or if you have a family history of serious illness, you should consider the more comprehensive Medigap plans like Plans G, N, and D. If you’ve been in excellent health, and you want Medigap coverage “just in case” you might consider a less comprehensive plan like Plan A, B, or L. A part of your consideration should also take into account the cost for your coverage. As a general rule, the more out of pocket costs you’re responsible for, the less expensive the coverage tends to be. The premiums also generally rise at a slower rate for plans that call for you to share more in the costs.

FAQ About Georgia Medicare Supplement Plans

When is the best time to enroll in a Medigap Plan?

The best time to enroll is during your Open Enrollment Period for Medicare Supplement. This one-time window opens when you are age 65 or older and also active in Part B. It lasts for six months. If you apply during this time, your coverage is guaranteed, and you can’t be charged more based on your health.

Can I change Medicare Supplement Plans?

Potentially. You have the right to apply for any Medigap plan available in your state. However, if you apply outside of your Open Enrollment Period, you’ll probably have to answer health history questions. It is possible that your application can be declined, or you could be charged more based on your health.

Can I switch to Medicare Advantage from Medigap?

Yes. You can do this during the Medicare Annual Election Period (AEP), which runs from October 15th to December 7th.

Do Medigap plans cover prescription drugs?

No. You will need to also enroll in a Medicare Part D prescription drug plan.

Do Medigap plans cover dental, vision, or hearing costs?

No. If you want help with those costs, you’ll have to consider adding standalone coverage.

Selection Matters Most When You Choose a Medicare Supplement Plan

Every Medicare Supplement plan with the same plan letter (F, G, etc) offers precisely the same benefits to you, but prices vary widely from one insurer to another. It’s in your best interest to have access to as many plans by as many insurers as possible when you make your Medicare Supplement plan.

That’s where Medicare Consumer comes in. When you speak with our experts you get access to plans from dozens of different insurers. They’ll guide you to the right plan for you at the best possible rate.

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MedicareConsumer.com is a non-government agency and is on a mission to help current and future Medicare recipients find the best Medicare supplement plan for their unique needs. Medicare insurance logos as seen on MedicareConsumer.com belong to the respected trademark owners in our available network of Medicare insurance carriers. Any and all rate quotes for Medicare supplement plans are free to consumers and you are not obligated to purchase any plan from any carrier.

Participating sales agencies do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1–800–MEDICARE to get information on all of your options.

Participating sales agencies represent Medicare Advantage [HMO, PPO, PFFS, and PDP]organizations that are contracted with Medicare. Enrollment depends on the plan’s contract renewal.

Enrollment in the described plan type may be limited to certain times of the year unless you qualify for a special enrollment period.

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