The Ultimate Guide to Medicare Supplement Plans in Georgia

The Ultimate Guide to Medicare Supplement Plans in Georgia
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The Ultimate Guide to Medicare Supplement Plans in Georgia

The Ultimate Guide to Medicare Supplement Plans in Georgia
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While the federal Medicare program is a great way for over-65s to lower their medical expenses, they are often surprised to find that Original Medicare won’t cover all their costs.

One way that people in Georgia cover these expenses is through private Medicare plans, such as Medicare Supplement Insurance and Medicare Advantage.

This article will look at Medicare Supplement Insurance in Georgia, go over the most popular plans, tell you when you should apply, and how much you'll pay.

Let’s Recap: What Are Medicare Supplement Plans?

Medicare Supplement Insurance (also known as a Medigap plan) is health insurance that helps to pay for out-of-pocket costs that Original Medicare won’t cover.

You can get a Medicare Supplement Insurance Plan if you have Original Medicare and you are not a member of a Medicare Advantage (Part C) or Prescription Drug Plan (Part D).

There are ten standardized Supplement Plans in Georgia that private health insurance companies can sell. 

Each plan can be identified by a letter: A, B, C, D, F, G, K, L, M and N. 

There are also two high-deductible versions of Plan F and Plan G. These are plans that have lower monthly premiums but have a higher deductible charge (In 2021, this amount was $2,370.00)

These plans are the same in 47 states, which means that if you join Plan N in Georgia you’ll get the same benefits as someone in Texas or New York.

However, Wisconsin, Minnesota, and Massachusetts have their own Medicare Supplement Plans with different benefits.

Terms You Need to Know: 

Deductible: This refers to the set amount you pay for health care services before health insurance companies begin to cover your bills.

For example, if you have a $1,200 deductible you have to pay $1,200 before your insurance will cover your medical expenses.

Coinsurance: The percentage of costs you are required to pay for services, tests, and items. 

Copayment: A set rate you must pay for doctor visits, hospital stays and prescription drugs. 

Out-of-pocket expenses: This term refers to costs that are not covered by Medicare and that you must pay for yourself. For example, a fee for a visit to the dentist or the cost of a new pair of glasses.

The amount of coverage you receive will depend on which Medicare Supplement Plan you choose.

Each plan will generally cover these kinds of expenses:

  • Your deductibles: The amount you need to pay before your Medicare plan begins to cover your medical expenses.

  • Coinsurance: The portion of health care costs you must pay (for Medicare Part B, this is 20% of the costs, and for Part A this is a daily rate).

  • Other out-of-pocket costs: This can include blood transfusions and foreign emergency cover, which Original Medicare doesn’t pay for.

If you would like to take a more detailed look at Medicare Supplement Plans and what they offer, be sure to read this article. 

 

Key Takeaways:

  • Medicare Supplement Insurance Plans help with expenses that Original Medicare doesn’t cover.
  • There are ten different Medicare Supplement Plan types you can choose from in Georgia. They can be identified by a letter: A, B, C, D, F, G, K, L, M and N.
  • If you already have Medicaid or a Medicare Advantage Plan, health insurance companies cannot sell you a Medicare Supplement Plan. 

When Is the Best Time to Enroll in a Medicare Supplement Plan in Georgia? 

Although you can enroll for a Medicare Supplement Plan at any time of the year in Georgia, the recommended time to do it is during your Open Enrollment Period. 

This is because you are likely to get better Medicare premiums, have more options available to you and you will not need to go through medical underwriting. 

 

Key Definition: What Is Medical Underwriting?

Medical underwriting is a review of your medical history. Health insurance companies perform medical underwriting to decide 

  • Whether they will accept people for certain plans.
  • How much they will have to pay to join.
  • How long people will have to wait before their medical expenses are covered. 

When Does the Open Enrollment Period (OEP) Begin?

In general, this window only happens once in your life when you turn 65, unless you collect Social Security Disability Income.

Your OEP will last for six months, beginning on the first day of the month that your Medicare Part B cover starts. 

For example, if you enroll for Medicare Part B and your coverage begins on April 1st, your Open Enrollment Period ends on September 1st.

People often mix up the Open Enrollment Period with their Initial Enrollment Period. Here’s how they’re different:

Key Point: Open Enrollment Period vs Initial Enrollment Period

Initial Enrollment Period Open Enrollment Period
What is it for? If you want to join the Original Medicare (Part A and B). If you want to join a Medicare Supplement Plan.
When does it start? 3 months before your 65th birthday month. The first day of the month that your Part B cover begins.
How long does it last? 7 months. 6 months.

The OEP is one of many Medicare enrollment periods that you should be aware of. Check out this table to see what others there are: 

Enrollment Period Description
Open Enrollment Period This six-month period begins on the first day of the month when you are 65 or older and enrolled in Medicare Part B. This date will be different for everyone and depends on the month that you sign up.
Fall Medicare Open Enrollment Period During this window, you can change your Medicare Supplement Insurance Plan without losing any medical coverage. This window takes place every year from October 15th to December 7th.
Initial Enrollment Period This is your first chance to sign up for Medicare once you are eligible and begins three months before your 65th birthday. During the IEP you can sign up for Medicare Parts A and B, a Medicare Advantage Plan or a Part D Prescription Drug Plan.
General Enrollment Period From January 1st to March 31st you can sign up for Medicare Parts A and B, as well as a Medicare Advantage Plan if you missed the deadline.
Special Enrollment Period This period refers to specific situations where you can enroll outside the regular enrollment periods (for example, if you move states or if your health care coverage under an employer ends). The dates for the Special Enrollment Period differ from person to person.

For more information, feel free to read our guide to Medicare Open Enrollment Period 2022.

An elderly woman reading about the different enrollment periods.

(Source: Pexels)

What Are the Most Popular Medicare Supplement Plans? 

In Georgia, there are twelve Medicare Supplement Insurance Plans that you can choose from. 

They are Plan A, B, C, D, F, G, K, L, M, N, and high deductible versions of Plan F and G.

Key Point - What are high-deductible Medicare Supplement Insurance Plans?

High-deductible plans have a low monthly premium but a very high deductible (the amount of money you need to pay before your insurance covers your medical expenses - for example, the Plan G high deductible is $2,320 in 2021).

The table below summarizes the basic benefits that each plan covers. 

Where you see a percentage, Medicare Supplement Insurance covers that percentage of the benefit and you must pay the rest. For example, if it says 100%, it means your expenses are fully covered by the plan.

The basic benefits that each plan covers.

Some of these Medicare plans have important details you should be aware of. For example:

  • Plans K and L have out-of-pocket limits of $6,220 and $3,110. Once you have paid these amounts and the Part B deductible of $233.00, the plan will pay 100% of your covered services for the rest of the year. 

  • Plans C and F aren’t available to people who are newly eligible for Medicare Supplement Insurance on or after January 1, 2020. 

  • Plan N will pay 100% of the Part B coinsurance. However, you will have to pay up to $20 for doctor visits and $50 to go to the emergency room (as long as you are not admitted to the hospital). 

A Recap of Key Terms:

Deductible: This refers to the set amount you pay for health care services before your insurance begins to pay. 

Coinsurance: The percentage of costs you pay after your deductible has been met. 

Copayment: A set rate you must pay for doctor visits, hospital stays and prescriptions.

Let’s Take a Look at the Most Popular Supplement Plans in Georgia 

Of the Medicare Supplement Insurance Plans available in Georgia, research shows that Plan F, G and N were the most popular in 2019. 

  

Medicare Supplement Plan Enrollment Numbers (2019) 

  • Plan F: 188,764
  • Plan G: 116,207
  • Plan N: 37,396

 

Medicare Supplement Insurance Plan F

In Georgia, Plan F is popular because it covers almost all Part A and B expenses such as deductibles and coinsurance. 

There is a standard and a high-deductible version of Plan F. If you purchase the high-deductible plan, you’ll have to pay a $2,370 deductible before your plan starts to cover you.

Unfortunately, Plan F is not available to people who became eligible for Medicare after January 1, 2020. This is because Medicare now prohibits supplemental insurance plans that cover the Part B deductible.

But if you were eligible for Medicare before 2020, you might still be able to purchase Plan F in Georgia.

If you’d like to find out more about the eligibility requirements of Medicare Supplement Plan F and how much it could cost you, read this article. 

An older woman who is happy because she is eligible for Plan F in Georgia.

(Source: Pexels)

Medicare Supplement Insurance Plan G

Plan G is another popular choice to lower Medicare’s out-of-pocket costs. Like Plan F, Plan G also has a high-deductible option of $2,370, but this is only available to people who turned 65 before January 1, 2020.

The main difference between Plan F and the standard Plan G is that it does not cover the Medicare Part B deductible. 

Medicare Part B has an annual deductible of $233 and a minimum monthly premium of $170.10, which is based on income.

For more information on what Medicare Plan G covers and what you can expect to pay in monthly premiums, take a look at this article.  

Remember: 

Medicare Part B insurance covers outpatient services like specialist consultations, preventative services like screenings, and certain durable medical equipment costs like walkers or wheelchairs.

Medicare Supplement Insurance Plan N

Plan N also covers most of the Medicare benefits, except the Part B deductible and Part B excess charges. 

With Plan N, your Part B deductible is not covered. This means you will have to pay the $233 (annual fee) before Medicare and Plan N begins to cover your medical expenses. 

Excess charges are costs that are higher than the Medicare-approved amounts for services, tests, and items. 

For example, if you get a knee replacement that costs $100 more than the Medicare-approved amount:

  • Plan N won’t cover the excess amount. 

  • You will have to pay 20% (coinsurance) and Medicare will pay 80% of the cost.

  • You’ll also have to pay the excess amount ($100).

Our article on Medicare Plan N outlines everything you need to know about this Supplement Plan. If you are still unsure or have any questions about Georgia Medicare Supplement Insurance, contact one of PolicyScout’s friendly Medicare consultants. 

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How Much Do Medicare Supplement Plans Cost in Georgia?

 

Although the benefits of Medicare Supplement Insurance Plans are standardized, the price of the monthly premiums can vary and health insurance companies can set their prices for coverage.

Because of this, it’s important to remember that your location and lifestyle habits will also be considered when a health insurance company sets premiums. For example, health insurance companies may:

  • Want to provide Medicare Supplement Insurance primarily to non-smokers.

  • Only offer Medicare plans to people in select counties.

  • Have to charge higher prices to ensure their members get adequate coverage.

In general, there are three ways that an insurance company can set their premiums. These are:

  1. Community-rated: This premium is not based on your age. This means that the same monthly premium is charged to everyone. However, the price will vary according to inflation. 
  2. Issue-age rated: This premium will be based on the age you are when you buy the policy. Therefore, the premium is lower for people who buy it at a younger age and won’t change as you get older. 
  3. Attained-age rated: This premium is based on your current age and will go up as you get older. Although these premiums might be the least expensive at first, they will eventually become the most expensive and are also affected by inflation.

Let’s look at an example to give you an idea of how much Medicare Supplement Insurance could cost you in Georgia. 

Meet Michelle

 

Michelle is a 67-year old woman living in Savannah, Georgia. Her postal code is 31405 and she doesn’t use tobacco products. 

She’s looked at the different Medicare plans and is trying to decide between Medicare Supplement Insurance Plans C, G (high-deductible), and N. Let’s take a look at what these options will cost:

Pricing Disclaimer:

Please keep in mind that all of the prices and costs in this article should not be taken as the amount you will pay for Medicare Supplement Insurance.

All displayed prices and charges are subject to change. If you want to know how much supplemental insurance might cost you, contact PolicyScout to get an accurate estimate.

Michelle who is deciding which Medicare Plan to choose.

(Source: Pexels)

Plan C 

Michelle can buy Plan C because she turned 65 in 2019. If she turned 65 after January 1st 2020, she wouldn’t be allowed to purchase Plan C coverage.

In Savannah, Georgia, Medicare Supplement Plan C monthly premiums range between $136 and $330. But, this does not include the $170.10 standard monthly premium for Medicare Part B.

Example - Michelle’s Monthly Expenses for Plan C

Plan C Monthly Premium: $136.00 - $330.00

Part B Monthly Premium: $170.10

Total Monthly Costs: $306.10 - $500.10 

Michelle will also not have any copayments or coinsurance or Part A and B deductibles, but if she uses a medical provider that charges more than Medicare-approved amounts, she will have to pay the difference.

If she needs to go to the hospital or requires care in a skilled nursing facility, she won’t have to pay any of the costs. 

If she needs medical assistance while travelling overseas she will have to cover the first $250, then her plan will pay 80% of the cost.

Plan C Benefits:

 ✅ Skilled Nursing Facility 

✅ Part A Deductible 

✅ Part B Deductible 

❌ Part B Excess Charges 

✅  Foreign Travel Emergency Cover (80%)

Plan G (high deductible)

High deductible plans are for people who would like to save money on monthly fees but still have access to supplemental insurance if they need it.

With the high deductible version of Plan G, Michelle will not have any copayments or coinsurance, but she will still have to pay the Medicare Part B premium ($170.10) each month.

In Georgia, Medicare Plan G (high deductible) monthly premiums are between $40 and $59.

She will also have to pay a $2,370 deductible for the year to get full coverage for approved Part B and Part A procedures.

She will have foreign emergency travel benefits up to $50,000 and will also get the first 100 days of treatment at a skilled nursing facility covered.

Example - Michelle’s monthly expenses for Plan G (high deductible)

Part B Monthly Premium: $170.10

Medicare Plan G Monthly Premium: $40.00 - $59.00

Total Monthly costs: $210.10 - $229.10

Here’s a comparison of Michelle’s estimated costs for a 90-day hospital stay on Original Medicare and Plan G:

Part A expenses: Original Medicare vs Plan G

Original Medicare Original Medicare with Plan G coverage
Part A Deductible (2022): $1,556.00 Michelle will have to pay $2,370.00.
Day 1-60: $0 Her supplemental insurance will then cover all of the approved costs.
Day 61-90: $389.00 x 30 days ($11,670.00)
Total Costs: $13,226.00 Total Costs: $2,370.00

Plan G (High-deductible) Benefits:

 ✅ Skilled Nursing Facility (100-day limit)

✅ Part A Deductible 

❌ Part B Deductible 

✅ Part B Excess Charges 

✅ Foreign Travel Emergency

Plan N 

If Michelle chooses Medicare Supplement Insurance Plan N, she can expect a monthly premium of between $70 and $400. Like the other plans we’ve discussed, this does not include the $170.10 standard Part B premium.

On Plan N,  when Michelle visits the doctor or the emergency room, she will have copayments of $20 and $50.

She will also have to pay the $233 Medicare Part B deductible and can expect to pay excess charges for Part B expenses. 

Medicare Plan N also includes foreign travel emergency benefits and coverage for treatment in a skilled nursing facility.

Example - Michelle’s monthly expenses for Plan N

Part B Monthly Premium: $170.10

Medicare Plan N Monthly Premium: $70 - $400

Total Monthly costs: $240.10 - $570.10

Plan N Benefits:

 ✅ Skilled Nursing Facility 

✅ Part A Deductible 

❌ Part B Deductible 

❌ Part B Excess Charges 

✅ Foreign Travel Emergency

The table below summarizes the costs and benefits of each of the Medicare Supplement Insurance Plans Michelle is interested in: 

Plan C Plan G (high-deductible) Plan N
Monthly premiums $102 to $311. $40 to $59. $70 to $400.
Medicare Part B premium cover No No No
Copayments None for approved Part B (outpatient) services. None for approved Part B (outpatient) services. $20 for visits to the doctor.$50 for visits to the hospital.
Deductible costs $233 (Part B) $233 (Part B) $233 (Part B)
Foreign Travel Emergency Cover Yes Yes Yes
Part B Excess Charges Not covered Covered Not covered

As you can see, each Medicare Supplement Plan has different benefits and costs. Our advice is to research your plan options before you sign up.  

It’s also a good idea to shop around and compare different providers. Look at the insurance company’s history, their areas of coverage, and their price when you’re weighing up your options.

An elderly lady that is happy because she found the right Medicare Supplement Plan for her

(Source: Pexels)

Where Can I Find Out More about Medicare and Supplement Insurance? 

If you want to learn more about your Medicare Supplement Plan options, visit our Medicare Hub.

You’ll also find information about the federal Medicare program, Original Medicare, Medicare Advantage plans, Medicare costs and benefits, prescription drug coverage, and enrollment.

You’re always welcome to get in touch with one of our licensed Medicare consultants if you want more in-depth advice about providers and plans in your area.

We help seniors find great Medicare plans every day, so if you need more assistance reach out to us on 1-888-912-2132 or Help@PolicyScout.com.

 

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