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How Do Medicare Advantage Plans Work in Georgia?



Piedmont Columbus Regional Northside health insurance
Piedmont Columbus Regional Northside
100 Frist Ct
Columbus, GA 31909
Telephone: (706) 494-2100
Plus Code: G2MX+RG Columbus, Georgia


Until recently, there was only one way to go when it came to Medicare coverage.  First you would acquire Medicare coverage.  You would then supplement your coverage by purchasing a Medicare Supplement plan.  A stand-alone Medicare plan contains "gaps" in coverage that can lead to significant out-of-pocket costs for several possible medical circumstances.  There are a variety of Medicare supplement health plan options that provide different levels of supplement protection.  The various plan types are designated by letters of the alphabet (A-N).  Generally, the more comprehensive the coverage, the higher the cost of the supplement plan.

Good to know:  Talk to an independent agent.  An independent insurance agent is an essential resource when purchasing insurance.  An independent agent works with multiple different carriers, which is different from captive agents who can only sell insurance from the carrier they work for.  Working with an independent agent can help make sure that you are getting the best coverage, for the best price.

In Georgia, Medicare Advantage Plans are an "all in one" alternative to the Original Medicare / Supplement plan arrangement.  These plans are offered by private companies approved by Medicare.  If you join a Medicare Advantage Plan, you still have Medicare.  These "all in one" plans include Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance), and usually Medicare prescription drug (Part D).

Medicare Advantage Plans cover all services covered by original Medicare.  In addition, Advantage plans are required to offer at least the same level of coverage as the Original Medicare Part A and Part B coverage.  In almost every case, Advantage plans feature several attractive additional benefits that are not covered by original Medicare.  Dependent upon which Georgia advantage plan you choose, these benefits may include coverage for vision care, hearing aids, dental care, prescription drug coverage, transportation to and from medical facilities, and even fitness center membership.  The end result is a very comprehensive medical insurance plan.

If you enroll in a Medicare Advantage plan, you continue to pay your Medicare Part B premium.  The private insurer determines what the Medicare Advantage plan premium will be.  This premium amount will vary from one plan style to another.

Medicare Advantage plans tend to be significantly less expensive than Medicare Supplement coverage.  Some Medicare Advantage plans may have premiums as low as $0.

Copay costs may also be less with a Medicare Advantage plan.  For, example, if you visit a primary care physician under a Medicare Advantage plan, you may pay a copayment of $10.  However, if you visit a primary care physician under Original Medicare, you may have a coinsurance of 20%, which could be significantly more than $10.

A Medicare Advantage plan will limit your maximum out-of-pocket expense.  Once you have spent that maximum, you pay nothing for covered medical services for the remainder of the year.

Good to know:  High-deductible plans come at a cost: You'll pay less each month in terms of premiums, but if you do have to use any medical services, you'll pay out of pocket for longer thanks to that high deductible.  Still, if you're looking to lower your monthly costs and you're someone who doesn't frequent the doctor often, high-deductible plans are a valid option.
Medicare Advantage Rules and Guidelines

Medicare pays a fixed amount for your care each month to the companies offering Medicare Advantage Plans.  In turn, these companies must follow rules set by Medicare.

Each Medicare Advantage Plan can charge different Out-of-pocket costs.  They can also have different rules for how you get services – for example:

  • Whether you need a referral to see a specialist.
  • What shared medical costs you are responsible for.


Which Medicare Avantage Plan Carriers Are Available in Georgia?

Following is a list of some of the insurance companies that offer Medicare Advantage plans in Georgia:

  • Allwell - Georgia. (Several plan variations)
  • BayCarePlus. (Several plan variations)
  • BlueCross Total - Georgia.(Several plan variations)
  • Aetna - Georgia. (Several plan variations)
  • Allina Health - Georgia. (Several plan variations)
  • Humana. (Several plan variations)
  • BlueMedicare. (Several plan variations)
  • UnitedHealthcare. (Several plan variations)
  • AARP. (Several plan variations)
  • Bright Advantage. (Several plan variations)

Good to know:  Many plans don't provide drug benefits, or discounts, even on generics, until you reach your deductible, which is often in the thousands of dollars.  Instead of just accepting your insurance plan's lousy prescription drug benefit, try using websites such as Blinkhealth.com or Goodrx.com to shop around for the best price for your medication in your area.
For more information concerning Medicare Advantage, Medicare Supplement or Medicare Prescription Drug Plans, please give us a call.


Other articles:
Medicare Supplement Insurance Rates in Georgia.
Medicare Supplement Vs Medicare Advantage Plans.
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