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.Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved May 20, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles,Centers for Medicare & Medicaid Services. (2026). Final CY 2026 Part D Redesign Program Instructions - CMS. cms.gov. Retrieved Jun 22, 2026, from https://www.cms.gov/files/document/final-cy-2026-part-d-redesign-program-instruction.pdf,Centers for Medicare & Medicaid Services. (2026). 2026 ma part d landscape state state fact sheet. cms.gov. Retrieved Jul 11, 2026, from https://www.cms.gov/files/document/2026-ma-part-d-landscape-state-state-fact-sheet.pdf
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, 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.Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved May 20, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
| Cost | Amount |
|---|---|
| Monthly premium | $0 for most people (40+ quarters of work history) |
| Hospital deductible | $1,736 per benefit period |
| Hospital coinsurance, days 61-90 | $434 per day |
| Lifetime reserve days | $868 per day |
| SNF coinsurance, days 21-100 | $217 per day |
The hospital deductible went up $60 from 2025, and most people pay no Part A premium at all.Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved May 20, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles 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.Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved May 20, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
- Monthly premium: $202.90 (higher if your income is above $109,000 single or $218,000 married, under the income-related adjustment)Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Jun 22, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
- 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.Centers for Medicare & Medicaid Services. (n.d.). Avoid late enrollment penalties. medicare.gov. Retrieved Jul 15, 2026, from https://www.medicare.gov/basics/costs/medicare-costs/avoid-penalties
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, and most bundle in Part D drug coverage along with extras like dental, vision, and hearing.
Georgia leans heavily toward these plans. As of March 2026, CMS counted 2,016,427 people with Medicare in Georgia: 1,132,147 were enrolled in Medicare Advantage and other health plans, while 884,280 stayed in Original Medicare.Centers for Medicare & Medicaid Services. (2026). 2026 ma part d landscape state state fact sheet. cms.gov. Retrieved Jul 11, 2026, from https://www.cms.gov/files/document/2026-ma-part-d-landscape-state-state-fact-sheet.pdf 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, 88,345 of 163,340 beneficiaries were in Medicare Advantage and other health plans as of March 2026; in Camden County, 5,035 of 11,727.Centers for Medicare & Medicaid Services. (2026). 2026 ma part d landscape state state fact sheet. cms.gov. Retrieved Jul 11, 2026, from https://www.cms.gov/files/document/2026-ma-part-d-landscape-state-state-fact-sheet.pdf
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.Centers for Medicare & Medicaid Services. (2026). 2026 ma part d landscape state state fact sheet. cms.gov. Retrieved Jul 11, 2026, from https://www.cms.gov/files/document/2026-ma-part-d-landscape-state-state-fact-sheet.pdf
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.Centers for Medicare & Medicaid Services. (2026). 2026 ma part d landscape state state fact sheet. cms.gov. Retrieved Jul 11, 2026, from https://www.cms.gov/files/document/2026-ma-part-d-landscape-state-state-fact-sheet.pdf Nationally, the typical beneficiary can choose from about 32 Medicare Advantage plans with drug coverage for 2026.KFF. (2026). Medicare Beneficiaries Have 32 Medicare Advantage Prescription Drug Plans Available, on Average, for 2026. kff.org. Retrieved May 20, 2026, from https://www.kff.org/medicare/medicare-beneficiaries-have-32-medicare-advantage-prescription-drug-plans-available-on-average-for-2026/ 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.Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved May 20, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
- 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.
- 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.Centers for Medicare & Medicaid Services. (2026). Final CY 2026 Part D Redesign Program Instructions - CMS. cms.gov. Retrieved Jun 22, 2026, from https://www.cms.gov/files/document/final-cy-2026-part-d-redesign-program-instruction.pdf Part D now moves through three phases:
- Deductible: you pay full price until you meet your plan's deductible (up to $615 in 2026).Centers for Medicare & Medicaid Services. (n.d.). How much does Medicare drug coverage cost?. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/health-drug-plans/part-d/basics/costs
- Initial coverage: you pay copays or coinsurance while your plan and drug makers cover the rest.
- 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.Centers for Medicare & Medicaid Services. (2026). Final CY 2026 Part D Redesign Program Instructions - CMS. cms.gov. Retrieved Jun 22, 2026, from https://www.cms.gov/files/document/final-cy-2026-part-d-redesign-program-instruction.pdf It was $2,000 in 2025 and rises each year with Part D drug costs. The national base premium is $38.99 a month, though actual plan premiums are set by each carrier and vary.Centers for Medicare & Medicaid Services. (2026). Final CY 2026 Part D Redesign Program Instructions - CMS. cms.gov. Retrieved Jun 22, 2026, from https://www.cms.gov/files/document/final-cy-2026-part-d-redesign-program-instruction.pdf People who qualify for Extra Help often pay much less, sometimes nothing.
Not sure which Part D plan fits your prescriptions? Chat with Brevy's care navigator at brevy.com.
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 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.Centers for Medicare & Medicaid Services. (n.d.). When can I buy a Medigap policy?. medicare.gov. Retrieved May 28, 2026, from https://www.medicare.gov/health-drug-plans/medigap/ready-to-buy/when
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.Centers for Medicare & Medicaid Services. (2025). Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare (CMS/NAIC, 2025) - Medicare.gov. medicare.gov. Retrieved Jun 23, 2026, from https://www.medicare.gov/publications/02110-medigap-guide-health-insurance.pdf 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.Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved May 20, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
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.Centers for Medicare & Medicaid Services. (n.d.). When can I buy a Medigap policy?. medicare.gov. Retrieved May 28, 2026, from https://www.medicare.gov/health-drug-plans/medigap/ready-to-buy/when 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.Centers for Medicare & Medicaid Services. (n.d.). When can I buy a Medigap policy?. medicare.gov. Retrieved May 28, 2026, from https://www.medicare.gov/health-drug-plans/medigap/ready-to-buy/when
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.U.S. Social Security Administration. (2026). SSA - POMS: HI 00815.023 - Medicare Savings Programs Income and Resource Limits - 02/26/2026. secure.ssa.gov. Retrieved May 28, 2026, from https://secure.ssa.gov/poms.nsf/lnx/0600815023
| Program | Individual | Couple | What it pays |
|---|---|---|---|
| QMB | Up to $1,350 | Up to $1,824 | Part A and B premiums, deductibles, coinsurance |
| SLMB | Up to $1,616 | Up to $2,184 | Part B premium |
| QI | Up to $1,816 | Up to $2,455 | Part B premium |
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.U.S. Social Security Administration. (2026). SSA - POMS: HI 00815.023 - Medicare Savings Programs Income and Resource Limits - 02/26/2026. secure.ssa.gov. Retrieved May 28, 2026, from https://secure.ssa.gov/poms.nsf/lnx/0600815023 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.U.S. Social Security Administration. (n.d.). Apply for Medicare Part D Extra Help program. ssa.gov. Retrieved May 20, 2026, from https://www.ssa.gov/medicare/part-d-extra-help
- 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 HelpU.S. Social Security Administration. (2026). SSA - POMS: HI 00815.023 - Medicare Savings Programs Income and Resource Limits - 02/26/2026. secure.ssa.gov. Retrieved May 28, 2026, from https://secure.ssa.gov/poms.nsf/lnx/0600815023
Apply through Social Security at ssa.gov or call 1-800-772-1213.U.S. Social Security Administration. (n.d.). Apply for Medicare Part D Extra Help program. ssa.gov. Retrieved May 20, 2026, from https://www.ssa.gov/medicare/part-d-extra-help
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.Centers for Medicare & Medicaid Services. (n.d.). Special Needs Plans (SNP). medicare.gov. Retrieved May 28, 2026, from https://www.medicare.gov/health-drug-plans/health-plans/your-health-plan-options/SNP
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.Centers for Medicare & Medicaid Services. (n.d.). Special Needs Plans (SNP). medicare.gov. Retrieved May 28, 2026, from https://www.medicare.gov/health-drug-plans/health-plans/your-health-plan-options/SNP 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.Centers for Medicare & Medicaid Services. (n.d.). Special Needs Plans (SNP). medicare.gov. Retrieved May 28, 2026, from https://www.medicare.gov/health-drug-plans/health-plans/your-health-plan-options/SNP 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:Centers for Medicare & Medicaid Services. (n.d.). Open Enrollment. medicare.gov. Retrieved Jun 23, 2026, from https://www.medicare.gov/health-drug-plans/open-enrollment
| Period | Dates | What you can do |
|---|---|---|
| Initial Enrollment | 7 months around your 65th birthday | Sign up for Parts A, B, and D; pick MA or Medigap |
| Annual Open Enrollment | Oct 15 - Dec 7 | Switch MA plans, move between MA and Original Medicare, change Part D |
| MA Open Enrollment | Jan 1 - Mar 31 | Switch MA plans or drop MA for Original Medicare (if already in MA) |
| General Enrollment | Jan 1 - Mar 31 | Sign up for Part B if you missed your initial window (coverage starts the month after you enroll) |
| Medigap Open Enrollment | 6 months from age 65 + Part B | Buy any Medigap plan at the standard rate, no health screening |
Changes you make during Annual Open Enrollment, which runs October 15 to December 7, take effect the following January 1.Centers for Medicare & Medicaid Services. (n.d.). Open Enrollment. medicare.gov. Retrieved Jun 23, 2026, from https://www.medicare.gov/health-drug-plans/open-enrollment 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.shiphelp.org. (n.d.). SHIP National Technical Assistance Center — Georgia SHIP (GeorgiaCares). Retrieved Jul 15, 2026, from https://www.shiphelp.org/ships/georgia/
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.shiphelp.org. (n.d.). SHIP National Technical Assistance Center — Georgia SHIP (GeorgiaCares). Retrieved Jul 15, 2026, from https://www.shiphelp.org/ships/georgia/
Where to Call for Help
Frequently Asked Questions
What does Medicare cost in Georgia in 2026?
Most people pay $0 for Part A. The standard Part B premium is $202.90 a month with a $283 annual deductible.Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved May 20, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles Part D premiums vary by plan (the base is $38.99), and many Medicare Advantage plans charge no extra premium.Centers for Medicare & Medicaid Services. (2026). Final CY 2026 Part D Redesign Program Instructions - CMS. cms.gov. Retrieved Jun 22, 2026, from https://www.cms.gov/files/document/final-cy-2026-part-d-redesign-program-instruction.pdf Your total depends on the plan you pick and the care you use.
Does Georgia have a Medigap birthday rule?
No. Georgia has no annual birthday rule or other yearly window to switch Medigap plans without health questions.Centers for Medicare & Medicaid Services. (n.d.). When can I buy a Medigap policy?. medicare.gov. Retrieved May 28, 2026, from https://www.medicare.gov/health-drug-plans/medigap/ready-to-buy/when Your one guaranteed-issue window is the six months that begin when you're 65 and enrolled in Part B. After that, insurers can use medical underwriting, so the safest time to buy Medigap is during that initial window.
How do I get help paying for Medicare in Georgia?
Apply for a Medicare Savings Program through Georgia's Division of Family and Children Services at 1-877-423-4746 or on Georgia Gateway, and apply for Extra Help with Part D through Social Security at 1-800-772-1213.U.S. Social Security Administration. (2026). SSA - POMS: HI 00815.023 - Medicare Savings Programs Income and Resource Limits - 02/26/2026. secure.ssa.gov. Retrieved May 28, 2026, from https://secure.ssa.gov/poms.nsf/lnx/0600815023 QMB covers all your Medicare premiums and cost-sharing if your income and assets are under the 2026 limits. A GeorgiaCares counselor (1-866-552-4464) can walk you through both applications for free.shiphelp.org. (n.d.). SHIP National Technical Assistance Center — Georgia SHIP (GeorgiaCares). Retrieved Jul 15, 2026, from https://www.shiphelp.org/ships/georgia/
What happens if I have both Medicare and Georgia Medicaid?
You can enroll in a Dual Eligible Special Needs Plan that coordinates your Medicare and Medicaid coverage.Centers for Medicare & Medicaid Services. (n.d.). Special Needs Plans (SNP). medicare.gov. Retrieved May 28, 2026, from https://www.medicare.gov/health-drug-plans/health-plans/your-health-plan-options/SNP Georgia doesn't merge the two programs into one statewide plan, so Medicaid long-term services run separately through the Community Care Services Program and the SOURCE waiver. Medicaid also keeps paying costs Medicare doesn't, like long-term care.
Learn More
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.