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 Georgia SHIP (GeorgiaCares) at 1-866-552-4464, option 4, for free help from a certified counselor.5,6,7

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 2025.1 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.1,8

• 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.9

Medicare Advantage Plans in Georgia (Part C)

Medicare Advantage plans are an alternative to Original Medicare, sold by private insurers. They cover Part A and B services except hospice and a few other items, which Original Medicare keeps covering. Most bundle in Part D drug coverage along with extras like dental, vision, and hearing.8

Georgia leans heavily toward these plans. As of March 2026, CMS counted 2,024,284 people with Medicare in Georgia: 1,132,173 were enrolled in Medicare Advantage and other health plans, while 892,111 stayed in Original Medicare.3 ("Medicare Advantage and other health plans" is CMS's own category, so the count is not of Medicare Advantage plans alone.)

How common that choice is depends on where in Georgia you live. In Fulton County, 88,164 of 163,791 beneficiaries were in Medicare Advantage and other health plans as of March 2026; in Camden County, 5,054 of 11,752.3

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 2026.10 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.8
• 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 what you pay out of pocket each year for in-network Part A and Part B services (plans that cover out-of-network care set a second, higher cap for combined costs). 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.8
• 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. Outside the yearly windows, certain life events, like moving or losing other insurance coverage, may open a Special Enrollment Period to change your health or drug plan.11

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).12
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 no copays or coinsurance 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.8 In Georgia, these policies are regulated by the Georgia Office of Commissioner of Insurance and Safety Fire.4

Medigap policies are standardized: outside Massachusetts, Minnesota, and Wisconsin they're sold as lettered plans (A, B, C, D, F, G, K, L, M, and N), and every policy with the same letter offers the same basic benefits, whichever insurer sells it.13 Plans C and F can't be sold to people who turned 65 and got Part A on or after January 1, 2020. If you had Medicare through a disability or End-Stage Renal Disease (ESRD) before 2020, or were eligible before 2020 but haven't enrolled, you may still be able to buy them.13,14 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 2026.1,13

Your One Guaranteed Window

Your strongest opening is Georgia's Medigap Open Enrollment Period, the six months that begin when you're 65 and enrolled in Part B. During that window an insurer can't refuse you or charge you more because of your health, and must offer you every Medigap policy it sells.4 One limit: with under six months of prior creditable coverage, a policy can delay covering a condition treated or diagnosed in the six months before coverage starts, for up to six months, minus the coverage you had.4

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 and may turn you down based on your health, unless you have a guaranteed-issue right. Those rights are triggered by an event, not a date: Georgia's regulation lists them, and they include an employer plan that supplements Medicare ending and certain situations while you're in a Medicare Advantage plan. If your coverage changes, ask whether one applies to you.4 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 Georgia SHIP before you count on one.4,6 CMS notes you'll probably have more Medigap options and be able to get a lower premium once your open enrollment window opens at 65.4 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 a policy issued after that rule took effect shouldn't carry a premium that climbs simply because you've had another birthday. It can still rise with inflation and approved rate increases, and the ban reaches only policies issued after the rule took effect, so don't assume it covers an older policy.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.8 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. Trying Medicare Advantage isn't always a one-way door: if you join a Medicare Advantage plan for the first time and aren't happy with it, federal trial rights let you buy a Medigap policy if you return to Original Medicare within 12 months of joining.8 Outside that trial period and the event-based rights above, Georgia gives you no yearly second chance at Medigap without health questions, so weigh that trade carefully before your window closes.4

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.15

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.15

QMB is the most generous, covering your Part B premium plus your deductibles and coinsurance. Georgia applies an asset test for all three programs. Georgia's July 2026 DFCS policy manual lists $9,660 for one person and $14,910 for a couple, but $9,660 is the 2025 federal figure; the federal 2026 limit for one person is $9,950, so apply if you fall between them. Don't go by the lower $7,390 and $11,090 on Georgia's undated MSP FAQ. That FAQ also says some assets don't count, such as your home, a car, and certain burial funds.15 These limits go up each year, so confirm the current figures with DFCS. Apply through your county DFCS office at 1-877-423-4746 or online at Georgia Gateway.15

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 your plan deductible is $0, and your premium is covered up to a limit 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.16

• 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 alone16
• Resource limits: $18,090 for an individual, $36,100 for a married couple. Social Security applies the lower $16,590 and $33,100 only if you report that none of your resources will go toward funeral or burial expenses. Your home, your car, and your personal possessions don't count16
• If you qualify for QMB, SLMB, or QI, you automatically qualify for Extra Help and don't need to apply for it separately15
• QDWI, the Medicare Savings Program for certain working people with disabilities who lost premium-free Part A, 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 separately15,16

Apply through Social Security at ssa.gov or call 1-800-772-1213.16

If You Have Both Medicare and Georgia Medicaid

Many people who have Medicare also qualify for Medicaid. If you have both, including full Georgia Medicaid, you may be able to join a Dual Eligible Special Needs Plan, a type of Medicare Advantage plan built for people with both coverages, as long as you have Part A and Part B and live in the plan's service area. Insurers decide where they sell these plans, so a D-SNP offered in one Georgia county may not be offered in the next; check the Medicare Plan Finder for your ZIP code.17

Medicaid long-term care works separately from any Medicare Advantage plan. Georgia Medicaid delivers long-term services at home through home- and community-based waivers, the Community Care Services Program and SOURCE, for older and disabled Georgians who otherwise qualify for a nursing facility level of care and who also meet the waivers' income, resource, and other criteria.17 The Georgia Department of Community Health also announced a moratorium on contracting with any new D-SNPs starting August 1, 2025, and has said further updates will follow.17 The PACE (Program of All-Inclusive Care for the Elderly) program is another route: a participant gets all Medicare and Medicaid benefits through one PACE organization, and joining it ends enrollment in a Medicare Advantage plan or a home- and community-based services waiver.18,19

Medicare Enrollment Periods

Miss a deadline and you can face coverage gaps or permanent penalties. The key dates:11

Changes you make during Annual Open Enrollment, which runs October 15 to December 7, take effect the following January 1.11 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. Georgia SHIP, which the Georgia Department of Human Services directory lists as GeorgiaCares SHIP, is Georgia's State Health Insurance Assistance Program, and it gives free, unbiased information and assistance to Medicare beneficiaries and their caregivers.5,6,7 It's administered through the Georgia Department of Human Services Division of Aging Services, it is not affiliated with any insurance company, and it does not sell or solicit any type of insurance.5,7

A Georgia SHIP counselor can help you:

• Understand your health plan choices and enroll in a Medicare plan that meets your needs5
• Select a Medicare health or drug plan, or a Medigap policy6
• Apply for Medicare Savings Programs and Extra Help5
• Review medical notices and manage bills, and get help with Medicare appeals and grievances5,6

Call 1-866-552-4464 and select option 4 to reach a certified 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.