Medicare Advantage Plans in Georgia for the Elderly!!
For Georgia seniors seeking care under Medicare Advantage, there are several options of senior medical plans to choose from. They can choose between different providers and plan types, such as PPOs, SNPs, PFFS, and HMOs.
Also called Medicare Part C, Medicare Advantage is an alternative to Original Medicare Parts A and B. Its users purchase plans from third-party private insurance companies that vary in terms of coverage. The rate of use of Medicare Advantage plans differs from one state to another. Georgia’s Enrollment in Medicare Advantage is at 36% (higher than the national average of 34%) in 2019.
Thus, before purchasing a senior medical plan in Georgia, you should consult a local licensed insurance agent. An agent will discuss your current health conditions, needs, budget, and family health history and then present the most appropriate insurance
plans accordingly. Only when you are fully satisfied, the agent will complete the process.
Medicare Advantage Plans in Georgia
It is crucial to know that all Medicare Advantage plans are not created the same. In Georgia, seniors can choose senior medical plans that usually fall into the following categories:
Health Maintenance Organizations (HMOs)
Preferred Provider Organizations (PPOs)
Private Fee-For-Service (PFFS)
Special Needs Plans (SNPs)
1.Health Maintenance Organizations (HMOs):
Under HMO plans, members are required to choose in-network primary care providers and hospitals to cover their medical expenses. In case the care is received in an out-of-network healthcare facility, no part of the costs will be covered. Members of these plans require referrals from primary care physicians before making an appointment with a specialist. While premiums are lower than plans, their limitations on use can offset the potential savings.
2.Preferred Provider Organizations (PPOs):
PPOs provide higher flexibility than HMOs; however, they come with higher plan costs. Though members can receive full coverage for services by an in-network provider, a portion of the medical expense for out-of-network care is usually provided to the members. Since coverage can be far more limited, members are encouraged to receive care through in-network to save money. Besides, PPO members can see a specialist without any referral from a primary care physician. Some PPO plans also provide prescription drug coverage.
3.Private Fee-For-Service (PFFS):
PFFS plans often come with a pre-determined list of doctors, specialists, and services covered under the policy. Members receive the payout according to the stated limits only. On the high-side, unlike PPO and HMO plans, some PFFS plans apply to all providers or services approved for Medicare, regardless of any kind of network. You don’t have to choose a primary care doctor or need specialist referrals. Some PFFS plans also facilitate prescription drug coverage. While PFFS plans are cheaper than their counterparts, members are advised to contact the hospital staff to determine the coverage ability before scheduling an appointment or undergoing a treatment procedure.
4.Special Needs Plans (SNPs):
SNPs are intended to provide access for specific people rather than the general public. They cater to specifically those with disabilities or who suffer from specific types of chronic illnesses. They are provided in coordination with your medical provider to serve the unique needs. They essentially include prescription drug coverage.
Since each category has its benefits and limitations, consult a reliable licensed agent before choosing one of the senior medical plans in Georgia to maximize your care coverage and flexibility.