Best Medicare Advantage Plans in Georgia – If you live in Georgia and are looking for a Medicare Advantage plan, you’re fortunate to have quite a few options to choose from. While that might make your decision a little harder, it’s great to have multiple plans to compare so you can find the one that works best for you.
Today, we’re going to take a look at the presence of Medicare Advantage in Georgia and which types of plans and insurance companies you can work with.
Medicare Advantage Statistics in Georgia
Medicare Advantage (also known as Medicare Part C) increases in popularity across the country every year. Georgia has a higher enrollment rate than average. Of all the people eligible for Medicare in Georgia, about 42% of them choose a Medicare Advantage plan over other types of coverage.
If you’ve started learning about Medicare Advantage, you probably know why these plans are so popular. They offer very low monthly premiums and lots of extra benefits. More and more providers are accepting Medicare Advantage plans, which has certainly helped them gain traction in recent years.
Georgia offers about 110 different Medicare Advantage plans throughout the state. Plans vary by county since they are based on provider networks, so you won’t have access to all 11o of them. However, the average number of plans per county is about 35.
Medicare Advantage Options in Georgia
There are several types of Medicare Advantage plans, and you’ll need to know how each type works before enrolling. Georgia offers every kind of plan available, so again, you’ll have a few to choose from.
Health Maintenance Organizations
HMOs are one of the most popular types of Advantage plans. They often have $0 premiums and very low out-of-pocket costs. The only caveat is that you must get care within the plan’s network. Going outside of the network will leave you with no coverage, and you’ll be responsible for the entire medical bill. You’ll also need to get a referral from your physician before you see a specialist. Most HMOs include prescription drug coverage.
Preferred Provider Organizations
PPOs are just as popular as HMOs because they also have very low premiums (usually $0) and low out-of-pocket costs. The advantage to a PPO plan is that you do have some out-of-network coverage, though you may pay more by using a non-contracted provider. You won’t need to get a referral if you want to see a specialist, and PPO plans also usually include drug coverage.
Special Needs Plans
SNPs are only for individuals who meet additional requirements. They must either have a chronic condition (C-SNP), be institutionalized (I-SNP), or be eligible for both Medicare and Medicaid (D-SNP). Each type of SNP has their own enrollment requirements, and they can be very beneficial to those who qualify. SNP plans tailor their benefits, including their drug coverage, to the population they serve.
Private Fee-for-Service Plans
PFFS plans are not quite as popular as the other types, but they do work for some people. With a PFFS plan, you can see any Medicare-approved provider who also agrees to accept your plan’s payment terms, meaning their fee schedule. The plan dictates how much they pay providers, as well as how much their members pay for services. Prescription drugs are not often included in PFFS plans.
How to Choose a Medicare Advantage Plan in Georgia
Once you narrow down the kind of Medicare Advantage plan you want, you can compare the coverage and benefits of all plans that are within that category. There are many private insurance companies that offer these plans, so you’ll have a few to choose from.
Let’s discuss a few factors to compare within these plans.
Star Rating: You should consider the insurance company’s reputation. Carriers are given star ratings based on their performance, coverage, customer service, and claims processing. You should start by looking at plans that have a three to five-star rating.
Network: If you aren’t flexible on your providers, make sure they participate with your plan. If they are not in the plan’s network, look for a different plan. Otherwise, you could pay a lot more out-of-pocket.
Premium: The premium is the monthly amount you’ll have to pay to have the plan. Many plans in Georiga offer a $0 premium, but others may have a small monthly premium. Keep in mind that you are still responsible for paying the Part B premium as well.
Deductible: The deductible is the amount you must pay before coverage begins. The lower the deductible, the lower your initial out-of-pocket costs.
Copayments/Coinsurance: This might be the hardest thing to compare. You should find out how much your copay is for doctor‘s visits and specialist visits, as well as things like ambulance services, inpatient hospital stays, medical equipment, etc.
Maximum Out-of-Pocket: All Medicare Advantage plans have a “MOOP.” This is the maximum amount you would have to pay for services. The lower the MOOP, the better for you. Also, make sure you understand that plans often have a MOOP for in-network care and one for out-of-network care.
Extra Benefits: What else does the plan cover? Does it have prescription drug coverage? If so, does it cover your current medications? Also, look at additional benefits like dental, vision, and hearing care, as well as things like transportation, gym memberships, and over-the-counter medications. These plans have lots of bells and whistles, so make sure you’re getting the most of your benefits!
Choosing a Medicare Advantage plan is not always easy. Thankfully, that’s what we’re here for! Our licensed insurance agents will help you compare plans so you can decide which is best for you. Give us a call today to speak with one of our Medicare advisors.
