Medicare Advantage Plans in Georgia 2020

20 minute read| Updated for April, 2021
Key Takeaways:
  • Nearly 2 million Georgia residents are enrolled in Medicare. Almost 700,000 of these enrollees subscribe to Medicare Advantage plans. 
  • There are 127 Medicare Advantage plans available across Georgia, each offering benefits within the five subcategories of MA plans. 
  • Not all providers cover every county. Plan costs and benefits will also vary by zip code. 
  • You can only enroll in Medicare Advantage at certain times of the year outside of your initial eligibility period.

With over 100 Medicare Advantage plans offered at low premium rates, Georgia’s Medicare market stands out for its impressive accessibility. In this guide, we’ll cover the various types of Medicare Advantage plans offered in the state, the benefits of each, average costs, and local and regional insurance providers that sell them.

Medicare Advantage in Georgia: Quick Facts

Medicare Advantage is a subset of Medicare that’s provided by private insurance companies. It includes the basic hospital and medical insurance benefits of Original Medicare (also known as Medicare Part A and Medicare Part B), but with some bonus offerings, such as membership to fitness programs, and dental, vision, and hearing coverage. Most Medicare Advantage plans are also bundled with Medicare Part D prescription drug plans, but not all policies offer this perk. 

Georgia is home to more than 1.7 million people enrolled in Medicare. Around 40% of these beneficiaries are enrolled in a Medicare Advantage plan. The state’s average monthly Medicare Advantage premium is far less expensive than the national average, which is good news for the hundreds of thousands of people likely to enroll in MA plans this year. 

Here are some quick facts about Georgia’s Medicare Advantage landscape in 2020, according to the Centers for Medicare and Medicaid Services

  • In 2020, the average monthly MA premium is $16.18, down from $17.10 in 2019. The national average is around $23.
  • In 2019, there were 687,314 people enrolled in Medicare Advantage and just over 1 million enrolled in Original Medicare across Georgia. 
  • In 2019, 60% of Medicare enrollees chose Original Medicare, while 40% opted for Medicare Advantage or other plans. This statistic varies slightly from the national average, which posts 63% enrolled in Original Medicare and 37% enrolled in MA.  
  • There are 127 Medicare Advantage plans currently available in Georgia. 
  • All Medicare beneficiaries can get a MA plan with a $0 monthly premium, which is the lowest premium rate for MA plans.

Medicare Advantage Plans

Before we cover the various plans that are available in Georgia, it’s important for you to know how Medicare Advantage works. This will help you choose a plan that is specifically tailored to your individual needs. 

There are five subtypes of Medicare Advantage plans. Each subtype has its own model of coverage and cost-sharing: 

 

Health Maintenance Organization (HMO)

Preferred Provider Organization (PPO)

Private Fee For Service (PFFS)

Special Needs Plans (SNP)

Medical Savings Account (MSA)

What is it? 

Limits coverage to a network of providers

Offers in-network and out-of-network coverage, but you’ll save money by using in-network providers

The plan determines how much a member pays for services; Offers in-network and out-of-network coverage, but you’ll pay less by staying in the network

Offers a tailored plan for people with specific health conditions and health care needs

A high-deductible plan that deposits money into a provider-selected bank account

Who is eligible?*

People who live/work in the plan’s service area

People who live/work in the plan’s service area

People who live/work in the plan’s service area

People who: have certain chronic conditions; live in an institution or require at-home care; or meet other criteria

People who live/work in the plan’s service area

Does it offer drug coverage?

Yes for most plans

Yes for most plans

Yes for some plans and prescriptions

Yes

No

Do doctors and other providers have to be in-network to be covered?  

Yes, except in an emergency

Yes, except in an emergency

Yes if your plan has a network

Depends if your plan covers out-of-network services

Depends on the plan

Is a referral needed to see a specialist? 

Yes for most plans

No

No

Yes for most plans

Depends on the plan

* Assuming you’re eligible for and/or enrolled in Medicare Part A and Part B

As you shop for plans, be sure to weigh any potential copayments and coinsurance costs you might have under the plan’s cost-sharing model.

Top Medicare Advantage Insurance Providers in Georgia

There are 127 Medicare Advantage plans currently available in Georgia, according to 2020 data from CMS. The cost and benefits will vary depending on the county you live in and what provider you choose. 

Here are some Medical Advantage insurance companies and plans covering the state of Georgia. It is important to note that not all providers offer the same plans in all areas. To see if a specific plan listed below covers your zip code,click on the corresponding links:

Aetna:

  • Aetna Medicare Advantra Preferred Plan (PPO)
  • Aetna Medicare Basics Plan (PPO)
  • Aetna Medicare Essential Plan (PPO)
  • Aetna Medicare Select Plan (HMO)
  • Aetna Medicare Plus Plan (PPO)

Anthem Blue Cross and Blue Shield:

  • Anthem MediBlue (HMO)
  • Anthem MediBlue (PPO)
  • Anthem Dual Eligible Special Needs Plans

Humana

  • HumanaChoice (PPO, SNP)
  • Humana Gold Choice (PFFS)
  • Humana Gold Plus (HMO and SNP)

Kaiser Permanente

  • Senior Advantage Basic (HMO) 
  • Senior Advantage Enhanced (HMO)

UnitedHealthcare AARP Medicare Advantage Plans

UnitedHealthcare:

  • UnitedHealthcare MedicareComplete Choice (Regional PPO)
  • UnitedHealthcare MedicareComplete Choice Plan 1 (PPO)

Enrollment Periods and Cost Considerations

The best time to enroll in a Medicare Advantage plan is during your Initial Enrollment Period (IEP), which starts three months before your 65th birthday (when you become eligible for Social Security benefits), includes your birthday month, and extends coverage for three months after your birthday. 

In the annual Open Enrollment Period, which occurs from October 15 to December 7 each year, existing Medicare Advantage members can switch to another MA plan or return to Original Medicare. 

In the Medicare Advantage Open Enrollment Period, which occurs from January 1 to March 31 each year, existing MA members can make changes to their plan or switch to another MA plan. 

If you missed these deadlines, you can still sign up during what is known as a Special Enrollment Period if you meet the necessary circumstantial criteria

As you shop for plans, be sure to weigh any potential copayments and coinsurance costs you might have under the plan’s cost-sharing model. Though the average Medicare Advantage premium in Georgia is just over $16 in 2020, you will still have to pay the separate premium of Medicare Part B coverage, regardless of what your MA premium is. This means that even if your MA premium is $0, you’ll still have to pay the 2020 Part B premium requirement of $144.60. 

Costs will vary depending on your county and the plans offered by the insurance provider. You can use the Medicare.gov ‘Find a Plan’ tool to compare the specific plans available in your zip code.