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Metter, Georgia Medicare

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If you are looking for Medicare in Metter, Georgia, look no further! Whether you are a seasoned Medicare beneficiary or brand new to the program, we can help. No matter which group you find yourself in, it’s helpful to review how the program works and your Medicare options in Metter, GA.

What is Medicare?

The Medicare program was established in 1965 by President Lyndon Johnson. It is one of the programs operated by the federal government and was initially designed to provide healthcare coverage for retirees. Prior to 1965, there were very limited options for individual healthcare insurance. The Medicare program continues to evolve but has always offered significant healthcare benefits to its beneficiaries.

Who is eligible for Medicare?

Every United States citizen ages 65 and older are eligible for Medicare. Legal residents who have lived in the U.S. for five consecutive years are also eligible for coverage. In addition to those groups, individuals who have been on disability for two years are automatically enrolled in Medicare at the beginning of the 25th month. Finally, individuals who have End-Stage Renal Disease (ESRD) are automatically enrolled in Medicare upon diagnosis.

What is Original Medicare?

Original Medicare consists of two components: Parts A and B. Each part covers different healthcare aspects and has separate premiums, deductibles, and copays or coinsurance costs.

Medicare Part A

Medicare Part A is your hospital insurance. It helps pay for the room and board expenses during any inpatient hospital stay. The majority of Medicare beneficiaries receive premium-free Part A. The only requirement to receive Part A at no cost is that the individual (or their spouse) must have paid Medicare taxes for ten years. If you have not met that requirement, your premium will be based on how many quarters you paid Medicare taxes.

The Part A deductible applies to each benefit period. A benefit period begins on the day you are admitted as an inpatient to a hospital and ends when you have been hospital-free for 60 consecutive days. In 2022, the deductible is $1556 per benefit period. After you’ve met that deductible, your coinsurance cost will be based on how many days you have spent as an inpatient.

Medicare Part B

Medicare Part A covers outpatient expenses. It will provide coverage for visits to your doctor, surgeries, diagnostic tests and images, surgeries, durable medical equipment, and preventive services. You will pay a monthly premium for Part B, which is $170.10 in 2022. That is the standard premium that most individuals pay, but you could pay more if you have a high income.

In 2022, the Part B deductible is $233. Unlike the Part A deductible, the Part B deductible only has to be met once per calendar year. After that, Part B will cover about 80% of your outpatient expenses.

What is Medicare Part C?

Part C is also called Medicare Advantage. Medicare Advantage (MA) plans are sold by private insurance companies and are an all-in-one solution to your Medicare needs. They bundle the coverage you’ll have with Parts A and B and then offer extra benefits. There are many Part C plans on the market, but they vary based on location. The exact premium, deductible, copays, or coinsurance will be dependent on the specific Part C plan.

Senior couple exploring their options for Medicare in Georgia.
Medicare Advantage (MA) plans are sold by private insurance companies and are an all-in-one solution to your Medicare needs.

What Part C plans are available in Metter, Georgia?

Part C plans are not offered in every county. A Part C plan that is available in one county or state may not be available in another county or state. Availability largely depends on the providers in the area as Medicare Advantage plans require participants to stay within the plan’s network. 

A few of the popular plans and carriers of Medicare Advantage in Metter, GA are:

  • Anthem MediBlue (PPO)
  • AARP Medicare Advantage Plus (HMO-POS)
  • UnitedHealthcare Dual Complete (HMO-POS D-SNP)
  • HumanaChoice (PPO)

Remember, your choices will be restricted to where you live, and there are some plans that have other eligibility requirements.

What is Medicare Part D?

Medicare Part D includes all prescription drug plans. They can be purchased as a stand-alone plan or be included in a Medicare Advantage plan. Part D plans are sold by private insurance companies.

Your Part D premium will depend on the plan you choose. You’ll choose a plan based on the prescriptions you take. Each Part D plan has a drug formulary, which is a list of medications covered by the plan. The medications are divided into tiers. Medications in lower tiers cost less than those in higher tiers.

Most Part D plans use the standard deductible of $480. They may lower the deductible if they choose, but it can never exceed $480 in 2022. Prescriptions in tier 1 and sometimes in tier 2 do not typically apply to the deductible.

What Part D plans are available in Metter, Georgia?

Like the Medicare Advantage plans, Part D plans are different in every state and county. Some are offered all over the country, while others are only available in some areas. There are plenty of Part D options available to you in Metter, GA.

A few of the popular Part D carriers in Metter, GA are:

  • AARP
  • Anthem
  • Humana
  • Cigna
  • Mutual of Omaha
  • Elixir
  • Clear Spring
  • Wellcare

What other products are available for Medicare in Metter, Georgia?

Once you’re enrolled in Original Medicare, there are other products you may consider purchasing.

The first thing you’ll want to do after enrolling in Original Medicare is to choose between a Part C plan or a Medicare supplement – you can’t have both. Both types are meant to help with the expenses that aren’t paid for by Original Medicare, but they do work differently. Let’s talk a little more amount Medicare supplements.

Medicare supplements are also called Medigap plans. There are currently ten Medigap plans available: Plans A, B, C, D, F, G, K, L, M, and N. Private insurance companies can sell these plans, but the coverage is standardized. That means that your coverage in one of the Medigap plans will be the same, regardless of which company you purchase it from.

Medigap plans do not offer extra benefits like most Medicare Advantage plans. However, they offer more comprehensive coverage and are accepted across the United States.

If you choose a Medicare supplement instead of a Part C plan, you may also consider enrolling in a Dental, Vision, Hearing (DVH) plan, and you will need to enroll in a stand-alone Part D plan.

Medicare Advisors in Metter, Georgia

There are many components to Medicare and many things you’ll need to consider when it’s time to enroll. Thankfully, you don’t have to do it all on your own. Our licensed Medicare advisors in Metter, GA, specialize in all Medicare products. We can work with you to understand your needs and find the plan(s) that will offer you the coverage you’re looking for. Give our office a call today and schedule a complimentary consultation.

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