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, well over a hundred plan choices in most counties, 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 now pick a Medicare Advantage plan.

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 in Georgia (Part C)
• Medicare Part D: Prescription Drugs
• Medigap 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, contact Medicare at 1-800-633-4227 (1-800-MEDICARE) or GeorgiaCares at 1-866-552-4464.

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.

The hospital deductible went up $60 from 2025. A benefit period starts the day you're admitted and ends 60 days after you leave. Get readmitted after that, and the deductible applies again.

Part B (Medical Insurance)

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

• Monthly premium: $202.90 (higher if your income is above $109,000 single or $218,000 married, under the income-related adjustment)
• 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 other creditable coverage 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.

Medicare Advantage 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, and most bundle in Part D drug coverage along with extras like dental, vision, and hearing.

Georgia leans heavily toward these plans. As of mid-2024, about 55% of the state's roughly 1.94 million Medicare beneficiaries were enrolled in Medicare Advantage, a higher share than the country as a whole. Nationally, the typical beneficiary can choose from about 32 Medicare Advantage plans with drug coverage for 2026, and most Georgia counties offer well over a hundred plan options. Every Medicare-eligible Georgian has access to at least one $0-premium plan.

The Major Insurers in Georgia

The big Medicare Advantage names in Georgia include UnitedHealthcare, Humana, Aetna, Anthem Blue Cross Blue Shield of Georgia, and Wellcare. Kaiser Permanente is a notable Georgia option because it runs its own closed network of hospitals and doctors in metro Atlanta, so it works differently from the open-network HMO and PPO plans.

How These Plans Work

• You keep paying your Part B premium ($202.90) on top of any plan premium, though many plans charge $0 extra.
• Plans run on networks (HMO, PPO, or HMO-POS). Confirm your doctors are in-network before you enroll, which matters most with a closed model like Kaiser's.
• Every plan caps your annual out-of-pocket spending. Original Medicare has no such cap.
• 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. 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).
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. It was $2,000 in 2025 and rises with inflation. The base premium is $38.99 a month, though actual plan premiums vary, and increases are capped at 6% a year through 2029. People who qualify for Extra Help often pay much less, sometimes nothing.

Medigap in Georgia

Medigap policies are sold by private insurers to fill the gaps in Original Medicare: the deductibles, coinsurance, and copays. They work only with Original Medicare, never with Medicare Advantage. In Georgia, these policies are regulated by the Georgia Office of Commissioner of Insurance and Safety Fire.

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. 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.

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. Unlike a handful of states such as California and New York, Georgia has no annual "birthday rule" and no other yearly window that lets you switch Medigap plans without health questions. 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. State rules require Medigap insurers to also offer coverage to people under 65 who qualify for Medicare through a disability, and Georgia generally requires policies to use issue-age rating rather than attained-age rating, so your premium isn't supposed to climb just because you're getting older.

Medigap or Medicare Advantage?

You can't hold both. 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.

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. 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.

• Resource limits: $16,590 for an individual, $33,100 for a married couple
• If you qualify for QMB, SLMB, or QI, you're automatically enrolled in Extra Help

Apply through Social Security at ssa.gov or call 1-800-772-1213.

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.

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. 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. If your needs are more intensive, the PACE 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:

Changes you make during Annual Open Enrollment take effect the following January 1. 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 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.

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, denials, and appeals
• Spot and report Medicare fraud through the Senior Medicare Patrol

Call 1-866-552-4464 and select the GeorgiaCares option to reach a counselor near you.

Learn More

• Georgia Medicaid: Programs and Coverage
• Georgia Medicaid Eligibility and Income Limits
• Georgia Medicare Savings Programs
• Georgia Medicare Extra Help Program
• Georgia Medicaid Estate Recovery
• Georgia SOURCE Waiver

Find personalized help comparing your Medicare options in Georgia at brevy.com.

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.