Those who work and pay Medicare taxes during their career will be able to be insured under Medicare. In the U.S., Medicare is government-sponsored medical insurance that covers healthcare cost for those insured.
Medicare is a great healthcare plan for seniors, but this insurance doesn’t cover all medical costs. Medicare covers a large portion of the expenses, but there are costs that are not covered that Medicare beneficiaries must pay for. Some call this break in coverage a gap or hole in medical coverage.
Georgia Medigap Plans
Private insurance companies recognized the need for an insurance product that would help Medicare beneficiaries with the gap in coverage, so they designed a Supplemental or Medigap insurance that will assist with the expenses that Medicare doesn’t cover.
Insurance providers in the state of Georgia provide Medigap to Medicare recipients covered by Part A and B, these individuals must also be age 65 or older. There are Georgia Medigap plans available to those under 65 years old, but the rates won’t be the same compares to those who are older than 65.
Supplement insurance can benefit seniors by relieving some of the financial stress and worry, they have some security knowing their insurance coverage will pick up the gap that Medicare leaves. Another benefit can be gym memberships, like SilverSneakers, that some carriers include.
A Few State Health Facts
- In 2015, the number of residents receiving Medicare benefits was 45% male and 55% female
- In 2014, the state spent over 15 million in total on Medicare
- Between 1991-2014, Medicare state spending in Georgia increased annually, averaging 7.9%
- In 2014, the average amount an enrollee spent on Medicare was just over $10,000
- Between 1991-2014, Medicare spending per state enrollee increased annually, averaging 4.8%
Costs Covered by Georgia Medigap Insurance Plans
The costs for Georgia Medigap insurance plans will vary from person to person. Most doctors require a co-payment to be paid before services are rendered. Co-payments are also required when a person goes to a specialist. Again, those covered will receive assistance with these payments as well as for coinsurance and deductibles.
It’s important to realize, as a Medicare beneficiary you’re still obligated to pay your Medicare Part B premium. Georgia Medigap policies don’t cover this expense. According to Frank Hart, a licensed agent, it’s essential to understand that Medicare gap plans are individual plans, so those that are married cannot be covered under one plan. Each person must purchase their own coverage.
Eligibility Requirements for Medigap Plans in Georgia:
- Must be a resident of Georgia
- Must be covered under both Parts of Medicare, Part A and Part B
- Be at least 65 years of age or on disability
If a person doesn’t enroll in one of the GA Medigap plans during their Open Enrollment Period (OEP), the private insurance company can require you to go through medical underwriting prior to approval. The first day of the month after turning 65 & enrolled in Part B is considered your first day of Open Enrollment, this time frame lasts 6 months. A carrier cannot turn down an applicant because of pre-existing health conditions if they applied during their OEP.