Medicare Plans in Georgia: Coverage and Costs (2026)

If you're turning 65 in Georgia or helping a parent work out Medicare, you're looking at four parts, a plan menu that changes with your ZIP code, and costs that reset every January. The standard Part B premium for 2026 is $202.90 a month, the Part D donut hole is gone for good, and more than half of Georgia's Medicare beneficiaries have moved off Original Medicare into a Medicare Advantage plan.1,2,3

This guide walks through every piece of Medicare as it works for Georgians in 2026, what it costs, the plan choices in this state, and how to get help paying for it.

In This Guide

• Key Takeaways
• Original Medicare: Parts A and B
• Medicare Advantage Plans in Georgia (Part C)
• Medicare Part D: Prescription Drugs
• Medicare Supplement (Medigap) Plans in Georgia
• Help Paying for Medicare in Georgia
• If You Have Both Medicare and Georgia Medicaid
• Medicare Enrollment Periods
• Free Medicare Help: GeorgiaCares
• Frequently Asked Questions

About these numbers: The premiums and deductibles below come from CMS for calendar year 2026, effective January 1. Medicare costs change every year. For the most current figures, check Medicare's own cost pages or call GeorgiaCares (Georgia SHIP) at 1-866-552-4464 and a counselor will go over them with you at no cost.5

Original Medicare: Parts A and B

Original Medicare is run directly by the federal government, and it comes in two parts.

Part A (Hospital Insurance)

Part A covers inpatient hospital stays, limited skilled nursing facility care, hospice, and some home health care.1

The hospital deductible went up $60 from 2025, and most people pay no Part A premium at all.1 A benefit period starts the day you're admitted and ends once you have not received inpatient hospital care or skilled care in a skilled nursing facility for 60 days in a row. That clock can run while you are still in a facility, so someone who drops from skilled to custodial care can begin a new benefit period without leaving. Get care again after that, and the deductible applies again.1

Part B (Medical Insurance)

Part B covers doctor visits, outpatient care, preventive services, durable medical equipment, and mental health care. Original Medicare doesn't cover routine dental, vision, or hearing.1,6

• Monthly premium: $202.90 (higher if your income is above $109,000 single or $218,000 married, under the income-related adjustment)1
• Annual deductible: $283
• After the deductible: you pay 20% of the Medicare-approved amount for most services

Part B is technically optional, but nearly everyone signs up. Delay past your enrollment window without qualifying for a Special Enrollment Period or a Medicare Savings Program and you'll owe a late penalty of 10% for every 12 months you could have had it, for as long as you keep Part B. Creditable drug coverage is the Part D exception, not the Part B one.7

Medicare Advantage Plans in Georgia (Part C)

Medicare Advantage plans are an alternative to Original Medicare, sold by private insurers. They cover everything Parts A and B do, except hospice, which Original Medicare keeps covering. Most bundle in Part D drug coverage along with extras like dental, vision, and hearing.6

Georgia leans heavily toward these plans. As of March 2026, CMS counted 2,019,345 people with Medicare in Georgia: 1,132,430 were enrolled in Medicare Advantage and other health plans, while 886,915 stayed in Original Medicare.3 More than half of the state's Medicare beneficiaries have left Original Medicare behind. ("Medicare Advantage and other health plans" is CMS's own category, and it counts a small number of cost and PACE plans alongside Medicare Advantage proper.)

How common that choice is depends on where in Georgia you live. In Fulton County, 88,336 of 163,540 beneficiaries were in Medicare Advantage and other health plans as of March 2026; in Camden County, 5,038 of 11,746.3

How Many Plans You Can Actually Choose From

For the 2026 plan year, CMS reports 180 Medicare Advantage plans available in Georgia, up from 178 in 2025. 100% of people with Medicare in Georgia have access to a Medicare Advantage plan, and 100% have access to one with a $0 monthly premium, which is the lowest monthly premium in the state. The average monthly Medicare Advantage premium in Georgia changed from $13.76 in 2025 to $6.74 in 2026.3

That 180 is a statewide count, though, not the menu any one Georgian sees. Counting only plans open to general enrollment (leaving out special-needs and employer plans), KFF's analysis of the CMS landscape files puts Georgia's total at 102, and finds that the average Georgia beneficiary can choose from 47 plans, offered by an average of 8 insurers.3 Nationally, the typical beneficiary can choose from about 32 Medicare Advantage plans with drug coverage for 2026.8 Your ZIP code decides which plans are actually on your list, so run the Plan Finder for your address rather than working from the statewide number.

How These Plans Work

• You keep paying your Part B premium ($202.90 in 2026) on top of any plan premium, though many plans charge $0 extra.1 Some plans go further and may help pay part or all of your Part B premium.6
• Plans run on networks (HMO, PPO, or HMO-POS), and the tighter the network, the more it matters. Confirm your doctors are in-network before you enroll.
• Every plan caps your annual out-of-pocket spending. Original Medicare has no such cap: CMS says there is no yearly limit on what you pay out of pocket unless you have supplemental coverage such as Medigap, Medicaid, employer, retiree, or union coverage.6
• Extras vary widely. Compare the dental, vision, hearing, and transportation benefits, not just the premium.

Use the Medicare Plan Finder at medicare.gov to compare plans by ZIP code. Enter your doctors and prescriptions and it shows which plans cover them and your estimated cost. If your current plan leaves your area for 2026, you get a Special Enrollment Period to pick a new one.

Medicare Part D: Prescription Drugs

Part D covers outpatient prescription drugs. You can get it as a standalone plan paired with Original Medicare, or built into a Medicare Advantage plan.

The Inflation Reduction Act eliminated the old coverage gap, the donut hole, so that higher-cost middle stage is gone.2 Part D now moves through three phases:

1. Deductible: you pay full price until you meet your plan's deductible (up to $615 in 2026).9
2. Initial coverage: you pay copays or coinsurance while your plan and drug makers cover the rest.
3. Catastrophic: once your out-of-pocket spending reaches $2,100, you pay $0 for covered drugs the rest of the year.

That $2,100 cap is the number that matters most in Part D.2 It was $2,000 in 2025, and the 2026 figure is the one specified in the CY 2026 Rate Announcement. The national base premium is $38.99 a month, though actual plan premiums are set by each carrier and vary.2 People who qualify for Extra Help often pay much less, sometimes nothing.

Medicare Supplement (Medigap) Plans in Georgia

Medigap policies are sold by private insurers to fill the gaps in Original Medicare: the deductibles, coinsurance, and copays. They work with Original Medicare, and a Medigap policy can't pay a Medicare Advantage plan's copays, coinsurance, deductibles, or premiums. In Georgia, these policies are regulated by the Georgia Office of Commissioner of Insurance and Safety Fire.4

Georgia offers the federally standardized plans, labeled A, B, C, D, F, G, K, L, M, and N. Plans C and F are closed to anyone who became Medicare-eligible on or after January 1, 2020.10 Plan G is the popular pick for people newly eligible: it covers the Part A deductible, Part A and Part B coinsurance, and skilled nursing coinsurance, leaving only the $283 Part B deductible on you for 2026.1

Your One Guaranteed Window

Your strongest opening is the federal Medigap Open Enrollment Period, the six months that begin when you're 65 and enrolled in Part B. During that window an insurer has to sell you any plan it offers at the standard rate, no matter your health.

Here's the part Georgians most often get wrong. No rule in Georgia's Medigap regulations provides an annual "birthday rule" or any other yearly window that lets you switch Medigap plans without health questions.4 Once your six-month window closes, an insurer can use medical underwriting, which means it can charge you more or turn you down based on your health, unless a federal guaranteed-issue right applies. So the choice you make in those first six months carries real weight. If you think you might ever want Medigap, the safest time to buy is during that initial window.

Georgia does go beyond federal law in two ways worth knowing. First, federal law doesn't require insurers to sell Medigap to anyone under 65, but Georgia is one of the states that does: CMS lists Georgia among the states that require insurance companies to offer at least one kind of Medigap policy to people with Medicare under 65. States differ in how far that right reaches (some extend it to everyone under 65, others only to people who qualify through a disability or End-Stage Renal Disease), so confirm which plans you can actually buy with GeorgiaCares before you count on one. Expect to pay more than someone over 65 would.4 Second, Georgia bars attained-age pricing outright. State regulation prohibits an insurer from filing a Medigap rate structure "based upon attained age rating as a structure or methodology," so your premium shouldn't climb simply because you've had another birthday. It can still rise with inflation and approved rate increases.4

Medigap or Medicare Advantage?

While you're in a Medicare Advantage plan it's illegal for anyone to sell you a Medigap policy unless you're switching back to Original Medicare. Choose Medigap and you stay on Original Medicare with the freedom to see any provider who takes Medicare nationwide, at a higher monthly premium. Choose Medicare Advantage and you trade some of that freedom for a network and a lower upfront cost. Because Georgia won't guarantee you a second shot at Medigap after your first six months, weigh that trade carefully before your window closes.

Help Paying for Medicare in Georgia

If you're on a fixed income, two programs can cut your Medicare costs sharply.

Medicare Savings Programs

Georgia runs its Medicare Savings Programs through Georgia Medicaid, with eligibility handled by the Division of Family and Children Services. They pay some or all of your Medicare premiums and cost-sharing based on your income and assets.11

Those figures already include the $20 of monthly income these programs disregard, so a chart quoting the bare poverty level runs about $20 lower, and Medicare tells you to apply even if your income looks a little too high.11

QMB is the most generous, covering your Part B premium plus your deductibles and coinsurance, which adds up to meaningful savings over a year. Georgia applies an asset test for all three programs: the 2026 resource limit is $9,950 for one person and $14,910 for a couple, not counting your home, one car, and certain burial funds.11 The income limits above are tied to the federal poverty level and update between February and April each year, so confirm the current figures with Georgia Medicaid before you rule yourself in or out. Apply through your county DFCS office at 1-877-423-4746 or online at Georgia Gateway.

Extra Help for Part D

Extra Help, also called the Low-Income Subsidy, pays Part D premiums, deductibles, and copays for people with limited income and resources. Under Extra Help the plan premium and the plan deductible are both $0, but the premium half comes with a condition worth knowing before you choose a plan: Medicare pays the premium subsidy against your service area's regional benchmark premium, so if you pick a plan that costs more than the benchmark, you owe the difference yourself.12

• Income limits: $23,940 a year for an individual, $32,460 for a married couple, which is 150% of the 2026 federal poverty guidelines. Not every dollar counts toward that test, so apply rather than rule yourself out on income alone12
• Resource limits: $16,590 for an individual, $33,100 for a married couple, or $18,090 and $36,100 if you tell Social Security you expect to use some of your resources for burial expenses12
• If you qualify for QMB, SLMB, or QI, you're automatically enrolled in Extra Help11
• QDWI, the Medicare Savings Program for people who lost premium-free Part A after returning to work, pays the Part A premium but does not carry Extra Help with it, so a QDWI enrollee has to apply to Social Security for Extra Help separately11,12

Apply through Social Security at ssa.gov or call 1-800-772-1213.12

If You Have Both Medicare and Georgia Medicaid

Many people who have Medicare also qualify for Medicaid. If you're a dual eligible in Georgia, you can enroll in a Dual Eligible Special Needs Plan, a type of Medicare Advantage plan built for people with both coverages. For 2026, Georgia D-SNPs include plans from UnitedHealthcare Community Plan and CareSource.13

Georgia's integration of the two programs is more limited than in some states. There's no single statewide plan that fully merges your Medicare and Medicaid benefits the way California's Medi-Medi plans do. Instead, Medicaid long-term services for older adults run through home- and community-based waivers, the Community Care Services Program and SOURCE, rather than through one integrated plan.13 The Georgia Department of Community Health also stopped signing contracts with new D-SNPs as of August 2025, though plans already under contract keep operating.13 If your needs are more intensive, the PACE (Program of All-Inclusive Care for the Elderly) program is a fully integrated option in some Georgia areas.

Medicare Enrollment Periods

Miss a deadline and you can face coverage gaps or permanent penalties. The key dates:14

Changes you make during Annual Open Enrollment, which runs October 15 to December 7, take effect the following January 1.14 That's when most people review their plan and switch.

Free Medicare Help: GeorgiaCares

You don't have to figure this out by yourself, and you don't have to pay a broker to help. GeorgiaCares, now branded Georgia SHIP, is the state's free, unbiased Medicare counseling program, the local version of the federal State Health Insurance Assistance Program (SHIP). It's run by the Georgia Department of Human Services Division of Aging Services, and its counselors don't sell insurance and take no commissions.5

A GeorgiaCares counselor can help you:

• Understand your Medicare options and what each part covers
• Compare Medicare Advantage, Part D, and Medigap plans side by side
• Apply for Medicare Savings Programs and Extra Help
• Sort out billing problems, claims denials, and appeals

Call 1-866-552-4464 and select option 4 to reach a counselor, Monday through Friday, 8 a.m. to 5 p.m.5

Where to Call for Help

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The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.