Your Local and Honest Medicare Experts in Georgia!
Medicare Basics • First Steps • Medigap (Medicare Supplement) • Medicare Advantage • Medicare Part D
Medicare Basics
Our goal is to provide helpful information and honest advice for people turning 65 or retiring and trying to figure out Medicare for the first time. We are here to help you wade through your options and provide answers to your questions so you can make an educated decision about your Medicare coverage.
We go over the basics of Medicare on our website and we can help with any questions you might have, but we also recommend that you visit the official Medicare site at www.medicare.gov.
Medicare is the Federal health benefits program for US citizens and people living in the US legally as permanent residents that are:
- Age 65 or older
- Under age 65 with certain disabilities
- People with End Stage Renal Disease
Have questions? Read more below or call us now at 770-452-9335. You can also Click Here to book a free 15-minute telephone/video appointment with our lead agent Terri Potter.
First Steps to Consider When You Turn 65 or Retire
Before you sign up for Medicare you need to consider several things.
- Are you currently on an individual/family health plan prior to turning 65, such as a Marketplace ACA plan? If so, your initial decision should be easy. You will need to sign up for both Medicare Parts A and B when you first become eligible or face a penalty if you sign up later. Find the link to enroll in Medicare electronically on the following page.
- Do you currently have a group health plan through your employer? If so and you plan to remain on your group health plan you may want to delay Medicare. There are several things to consider first, give us a call and we will go over your options!
- Are you retiring? If you are already enrolled in Medicare Part A you can enroll for Part B by completing a form that will need to be partially completed by you and then signed by your Employer. That way you will not be penalized for signing up late for Medicare Part B.
- Are you already receiving Social Security benefits? If so, you will automatically be signed up for Parts A and B effective the first day of the month you turn 65.
Have questions? Read more below or call us now at 770-452-9335 or Click Here to book a free 15-minute telephone/video appointment with our Lead agent Terri Potter.
Medicare Choices
1. Medigap plans (Medicare Supplement) vs Medicare Advantage Plans
What is the difference between a Medicare Supplement plan and a Medicare Advantage plan?
- A Medicare Supplement plan, also called a Medigap plan, has a higher premium than a Medicare Advantage plan but a much lower out of pocket maximum.
- A Medicare Supplement plan does not have a restrictive network because you can use any doctor or facility that accepts Medicare. A Medicare Advantage Plan has a more restrictive network because the Doctors and facilities must also be in the plan network.
- A Medicare Advantage plan usually provides additional coverage that you do not get from Original Medicare and a Medigap plan, such as dental, vision, and hearing.
- You would purchase either a Medigap plan or an Advantage plan, but never both!
Which is best for you? Call us and we will help you decide!
2. Medicare Supplement Plans (Medigap Plans)
- Medicare Supplement plans, also referred to as Medigap plans, have been around since the 1980s. These plans do not replace your Original Medicare Parts A and B but work with Original Medicare to control your Out of Pocket costs.
- These plans are only available to purchase with original Medicare Parts A and B. You will also need to purchase your Part D drug coverage separately.
- Your Initial Open Enrollment period of 6 months surrounds the timetable when you first become eligible for Medicare. There are a few other guaranteed issue events as well.
- These plans are not available if you buy a Part C plan (an Advantage Plan), because you cannot be on both plans.
- Medigap plans pick up where Medicare leaves off. There are several different plans, but Plan G is the most popular. Plan G will cover most of the remaining cost of Medicare-approved services not paid by Medicare, after you pay the Part B Medicare deductible.
3. Medicare Advantage Plans: “Part C” or “MA Plans”
- You are required to sign up for Medicare Part A and Part B in order to purchase one of these types of plans. These plans are offered by private companies approved by Medicare.
- These plans are required to cover all the services that Original Medicare covers. They usually cover additional services as well (dental, vision, hearing, etc..).
- They are required to have an out of pocket maximum limit (usually around $5,000-$6,000).
- The cost-sharing on these plans is equal to original Medicare.
- There are different types of Medicare Advantage Plans. Many plans offer Part D drug coverage. These are called MAPD plans.
4. Part D Drug Plans
- These plans all have a monthly Premium that in Georgia is typically between $17 and $70.
- Most plans have a drug deductible between $100-$415 in Georgia.
- Part D plans have different formularies (lists) of covered drugs.
- There is an annual enrollment period during which you can change plans.
- You will be penalized if you do not sign up when you first become eligible.
Questions? Send us an email!
