Medicare Part D in Georgia: Plans and Coverage Options
As you get older, you may need to take more prescriptions to manage chronic conditions and stay healthy. While necessary, prescription medications can be expensive. Medicare Part D (prescription drug coverage) helps millions of older adults and people with disabilities afford medications.
In this blog post, we’ll focus on Medicare Part D in Georgia. By the end of this article, you’ll understand how Medicare drug plans work, your options in Georgia, and how to find the best plan for your needs.
Key takeaways:
Seven insurance providers in Georgia offer 20 Medicare prescription drug plans.
Wellcare, Humana, and UnitedHealthcare offer plans with higher Medicare star ratings.
What you pay for your coverage and prescriptions is unique to you, based on the coverage you choose and the prescriptions you need.
Generic drugs have lower copays, while brand-name and specialty medications have higher copays/coinsurance.
You can also enroll in a Medicare Advantage plan that includes prescription drug coverage. Consider the costs of the whole plan as well as prescription coverage when shopping for a plan.
Two key options for Medicare Part D in Georgia
There are two options for Medicare drug coverage. A person can get coverage through a standalone prescription drug plan or through a Medicare Advantage plan that includes drug coverage. People on Original Medicare typically enroll in a standalone prescription drug plan. Most Medicare Advantage plans include prescription coverage, but people enrolled in Medicare Advantage plans that don’t include it may choose to enroll in a standalone Part D plan.
In Georgia, 1.4 million people have Medicare Part D. 35% of these people have a standalone prescription drug plan, and 65% have drug coverage with a Medicare Advantage plan. We’ll break down your coverage options in the following sections.
Part D plans in Georgia
Seven insurance companies offer 20 prescription drug plans in Georgia. These providers are:
Aetna Medicare
Anthem
Cigna
Humana
Mutual of Omaha Rx
UnitedHealthcare
Wellcare
Drug plans by Wellcare, Humana, and UnitedHealthcare have the highest Medicare star ratings.
Costs of Medicare Part D plans in Georgia
Premiums for prescription drug plans in Georgia range from $0.50 per month (Wellcare Value Script) to $130.90 per month (Anthem MediBlue Rx Plus). However, premiums are just one cost to consider. You’ll also need to calculate your out-of-pocket costs for your prescriptions, which are determined by the prescriptions you take and the plan you choose. We explain more about how prescription pricing works later on.
Medicare Advantage plans in Georgia with drug coverage
Medicare Advantage plans are appealing for many reasons, and one big reason is that they usually include drug coverage at no extra cost. However, drug coverage is one piece of the whole plan. There are a number of Medicare Advantage plans in Georgia, but the availability of plans varies by county. Plans also vary with out-of-pocket costs and benefits. It’s important to understand the cost and coverage of the whole plan (medical and drug coverage) before enrolling to ensure it’s a good fit.
Medicare Part D plan and prescription costs
When comparing Part D coverage options, you should consider all of the following costs:
The plan premium you pay each month for coverage
Plan annual deductible, which cannot exceed $545 in 2024
Copay and coinsurance amounts you’ll pay for your prescriptions
These costs will vary between plans. Your prescriptions will also have different copay and coinsurance amounts based on which “tiers” they’re on.
Drug tiers and formularies
It’s helpful to understand two terms related to Part D: formularies and drug tiers. A formulary is a list of drugs that a plan covers. Check plan formularies to ensure all of your prescriptions are covered.
Insurance plans assign prescriptions to drug tiers, which determine their price. Prescriptions on lower tiers (like Tier 1) will cost less, while those on higher tiers will cost more.
How to find the right Medicare drug coverage for you
Everyone has different prescription needs. Focusing on your priorities is the key to finding the right Medicare drug coverage. If you’re on the hunt for a prescription plan, follow these three steps to select your coverage:
Step 1: Make a list of your prescription drugs and pharmacies of choice (there are in-network pharmacies for plans).
Step 2: Narrow down your plan options to those that cover your prescriptions. You can do this by plugging your prescriptions into Medicare.gov’s plan finder or by talking to one of our Medicare Advisors.
Step 3: Calculate your total costs for Part D and your prescriptions or get help from a Chapter Advisor who can do this for you quickly!
It’s worth noting that you have an opportunity to compare options and change your Part D coverage every year. You can do this during Medicare’s Open Enrollment Period. Three big changes can occur each year:
New plans can become available
Existing plans can change (including prices and covered drugs)
Your healthcare needs can change
Because of these possible changes, we suggest that you shop around every year to make sure you’re always saving the most money!
Our Chapter Medicare Advisors are always a phone call away if you need help comparing your Part D options or have any questions about Medicare. We’re here to make Medicare simple and find plans that fit your healthcare needs. Call us at 855-900-2427 or schedule a time to get help today.