Assisted living facilities primarily help residents with non-medical needs. Although minor and infrequent medical services, such as first-aid for a wound, can sometimes be met on-site by nurses. These communities may sometimes also be called ALFs, residential care facilities, retirement homes, or long-term care facilities.
The financial options available to help pay for senior care is dependent on, among other things, the type of care that is required. If you are just beginning the research process on how to pay for long-term care, it is helpful to have an idea about the type of care you or your loved one currently requires, as well as to anticipate future needs. In addition, it is important to be familiar with the associated eldercare terminology.
Can using home care technology help your family save money caring for an aging loved one? The answer is most certainly “Yes”. Our goal is not to provide a comprehensive list, but rather to make sense of those that are available on the market today and can reduce the care hours required by elderly persons. As such, they can reduce a family’s out-of-pocket care costs or reduce the hours they spend providing care themselves.
Medicare Advantage (Part C), a privately offered alternative to Original Medicare (Parts A and B), has grown in popularity over the years. Despite the growing popularity of Medicare Advantage, some seniors face obstacles that prevent them from truly understanding how it works and who it benefits. Common mistakes about Medicare Advantage include misunderstanding its differences from Original Medicare, getting it confused with other forms of private Medicare insurance (like Medigap or Part D), or not understanding how to look up or evaluate plans.
Seniors who are already enrolled in Medicare Part A and Medicare Part B can combine their benefits into a single plan with Medicare Advantage, also known as Medicare Part C. Instead of being provided by the federal government, Medicare Advantage is offered by private insurance providers. This gives seniors and other eligible individuals the opportunity to purchase better benefits than what’s offered by Original Medicare.
The government requires Medicare Advantage providers to at least offer the same coverage as Original Medicare; however, most providers opt to offer more extensive coverage options, including added benefits such as dental care, vision care, diet and nutrition programs, and even massage therapy, in some cases. Most Medicare Advantage plans also include prescription drug coverage, making it more convenient for seniors to access the medications they need without the need for an extra insurance plan.
Although there are minimum requirements for coverage offered by Medicare Advantage providers, there are no rules regarding premiums, copays or network regulations, which gives providers the freedom to design plans that suit the seniors they serve best. In Georgia, almost 1.8 million individuals are eligible for Medicare Advantage in 2020, and 42% of them are enrolled, which is on par with the national average of 42%.
This guide provides in-depth information about Georgia’s best Medicare Advantage plans, as well as important details regarding how Medicare Advantage works, what it costs and how to enroll.
The Top 10 Medicare Advantage Plans in Georgia
Georgia has many Medicare Advantage companies. Most offer a choice of plans to suit varying needs and budgets. The following table shows the nine most popular providers in Georgia in 2023, detailing the total number of people enrolled in all plans offered by each company. Pricing is given as a range to reflect the costs of differing policies. While all figures are current as of July 2023, individuals can visit Medicare.gov for further insights.
Name
Enrollment
Medicare Star Rating
Monthly Cost Range
Plan Types
Kaiser Permanente
271215
4.5
$0 – $71
PPO, HMO
UnitedHealthcare
213007
3
$0 – $49
PPO, HMO
Aetna Medicare
141686
3
$0 – $47
PPO, HMO
Humana
53676
2.5
$0 – $103
PPO, HMO, PFFS
Anthem Blue Cross and Blue Shield
28273
3
$0 – $59
PPO, HMO
Wellcare
11758
2.5
$0 – $85
PPO
Clover Health
8600
3.5
$0 – $37
PPO
Cigna
8172
3
$0 – $0
PPO, HMO
BlueCross BlueShield of Tennessee
1058
5
$0 – $0
PPO
How Medicare Advantage Plans Work in Georgia
Georgia’s Medicare Advantage providers offer a variety of different types of plans, so before enrolling in a plan, it’s important to understand what it’s offering and what its requirements are. The most popular Medicare Advantage plans include health maintenance organizations (HMOs) and preferred provider organizations (PPOs). The differences between these and other types of Medicare Advantage plans are outlined below.
What Medicare Advantage Plans Cover in Georgia
All Medicare Advantage plans in Georgia are required to provide coverage for the same health care services as Original Medicare, except hospice care. That includes services such as hospital care, primary care, lab tests and X-rays. Most Medicare Advantage plans also provide additional benefits, which might include vision care, dental and nutritional services.
Coverage Available With Medicare Parts A & B?
Coverage Available With Medicare Advantage?
Preventive Screenings
Yes
Yes
Hospital Care
Yes
Yes
Durable Medical Equipment
Yes
Yes
Prescription Drugs
No
Yes**
Vision Care
No
Yes*
Dental Care
No
Yes*
Hearing Aids
No
Yes*
*Select plans offer this coverage
** Most plans offer this coverage
Eligibility for Medicare Advantage in Georgia
Medicare Advantage plans are only available to seniors and other eligible individuals who are already enrolled in Medicare Part A and Medicare Part B. Furthermore, those who wish to enroll must also live within their plan’s service area.
It’s also required that new enrollees be eligible for Medicare. Eligibility guidelines include being at least 65 years or older and a United States citizen or legal alien/permanent resident.
When enrolling in a new Medicare Advantage plan, seniors must do so during their specified enrollment period. These periods only occur at certain times throughout the year, with the initial enrollment period falling within 3 months of the enrollee’s 65th birthday. These enrollment periods are explained in the list below.
Initial Coverage Election Period: This is the initial 7-month period, coinciding with one’s 65th birthday, during which everyone is eligible to enroll in a Medicare Advantage plan.
Annual Election Period (AEP): Also referred to as the Open Enrollment Period, this the time of year when anyone over 65 can enroll in Medicare Advantage for the first time or change to a new plan.
Medicare Advantage Open Enrollment Period: During this period, those who are already enrolled in Medicare Advantage can switch to a different plan or switch back to Original Medicare.
Start Date
End Date
Initial Coverage Election Period
3 Months Before One’s 65th Birth Month
3 Months After One’s 65th Birth Month
Annual Election Period (AEP)
October 15th
December 7th
Medicare Advantage Open Enrollment Period
January 1st
March 31st
Additionally, Medicare Advantage plan participants can change their plan outside of these enrollment periods under certain qualifying circumstances, such as moving to a new state.
How to Find & Choose a Medicare Advantage Plan in Georgia
Navigating the many intricacies of Medicare Advantage plan types, insurers, and the specific plan options available by region can be a difficult and time-consuming task. Below are several resources we’ve created to help you through the process.
First is a downloadable PDF that you can use as a guide to help you compare plans as you research. Finally, we have listed a number of organizations that you can contact with experts that will help you determine whether Medicare Advantage is right for you and what plans you should consider.
GeorgiaCares is a partnership between the Georgia Department of Human Services (DHS) and the Division of Aging Services (DAS) that provides free access to unbiased Medicare assistance. As the State Health Insurance Assistance Program, all seniors eligible for Medicare can use this resource to find the right Medicare enrollment option, as well as those seeking other forms of insurance support. The program is not associated with any insurance companies or providers, guaranteeing objective information on available insurance options. Counseling is available free of charge and can assist with understanding plan descriptions, explanations of benefits and the enrollment process. GeorgiaCares can also connect Medicare beneficiaries with financial assistance programs for those unable to afford premiums or out-of-pocket costs.
The Georgia Division of Aging Services is a subdivision of the Department of Human Services that advocates for the rights of seniors across the state of Georgia. As a comprehensive resource for seniors, this agency offers various forms of information and support to empower and protect the aging population. In addition to offering information on widespread community resources, the Division of Aging Services can also connect seniors with their local Agency on Aging location. Agencies on Aging can be excellent resources for seniors in need of support, offering information on medical insurance, such as Medicare, connecting seniors with financial assistance and providing assistance with costs of services, such as long-term care. Many Agencies on Aging can also provide confidential and unbiased counseling services to help seniors make educated decisions about health and welfare. All seniors and their caretakers in the state of Georgia can seek assistance from the Division of Aging Services.
Seniors can contact The Georgia Division of Aging Services by calling 1-404-657-5258 or calling the toll-free number at 1-866-552-4464, as well as through the website contact form or by mail.
The Georgia Department of Community Health is one of Georgia’s four health agencies committed to fostering healthy and empowered communities throughout the state. While the primary focus is Medicaid and PeachCare, Georgia’s subsidized insurance plan for children, Medicare information is available as well, including state-level updates on enrollment and how Medicare works with other health services throughout the state. Interested seniors can contact the Department of Community Health to learn more about how Medicare can support health care needs in the state of Georgia. This agency can also help support those seniors who qualify for both Medicare and Medicaid simultaneously and need help balancing benefits. All citizens of Georgia are welcome to seek assistance from the Georgia Department of Community Health.
The Georgia Department of Community Health can be contacted by phone at 1-404-656-4507 or through the contact forms on their website.
Georgians for a Healthy Future
Georgians for a Healthy Future is a consumer-focused health care advocacy group serving communities across the state of Georgia. The organization is dedicated to ensuring all Georgia residents have access to comprehensive health insurance, regardless of their chosen course of coverage. Georgians for a Healthy Future advocates for health care reform and is active in public policy changes. Seniors who need assistance with health insurance requirements can reach out to learn more about doctors, coverage options, tax implications and more. Anyone in Georgia seeking information about health insurance or who wants to get involved in health care advocacy is welcome to contact Georgians for a Healthy Future.
Empowerline is an Atlanta-based advocacy group that supports the needs of seniors and those with disabilities in the greater metro area. The organization covers many different topics for seniors, including comprehensive health care plan information. Free certified counselors are available around the clock to answer questions, provide information and help seniors and persons with disabilities make educated choices. This includes information about different Medicare plans, including Part C options, to ensure seniors understand their options and are able to find an affordable plan that meets their individual health needs. Empowerline also offers occasional in-person seminars on a variety of topics, including health insurance.
Senior Citizens Inc is a registered nonprofit agency that offers a variety of services encompassing physical, mental and emotional health support for seniors. This includes counseling services for Medicare participants. A representative with GeorgiaCares works directly with the organization to provide unbiased evaluation assistance. This service is available on Wednesdays from 1:00 p.m. to 5:00 p.m. In addition to Medicare counseling services, the agency can also provide numerous other services to seniors, including meal delivery, companionship through a companionship program, learning center access throughout the state and resources for in-home care. The organization serves four metro areas in Georgia: Chatham, Bryan, Effingham, and Liberty.