Georgia Health Services FAQs
If I am enrolled in Georgia Original Medicare coverage, then will I automatically be enrolled in Part C and D?
What is the difference between the Medicare Advantage Plan and Medicare Part C?
How much Medicare Extra Help is provided when applicants are approved?
Can you leave from the Medicare Advantage Program at any time?
How can I determine my exact Medicare effective date?
I need to allow Georgia Medicare to provide my personal health information to a friend or family member—what can I do?
What can I do to appoint a representative to help me file a Medicare appeal in Georgia?
How can I check my enrollment with Medicare online?
All beneficiaries who wish to check their enrollment with Medicare can use the website. The information needed to check enrollment online includes the applicant’s zip code, date of birth, Medicare number, effective date or benefits. This web tool can be used for current and future enrollment requests.
I lost my Medicare card, what do I do?
All Medicare applicants will receive a Medicare card, which is proof of health care insurance through the program. If a card is lost, destroyed or stolen, then applicants can ask for a replacement card online through their Social Security Account or by calling the toll free Medicare services number.
Can I use mail-order pharmacies instead of retail pharmacies for my Medicare-covered prescriptions?
Yes, approved applicants within the Medicare program can use legal mail-order pharmacies if they so choose. Many applicants will use a mail-order pharmacy in order to find more cost-efficient prescription medication. For applicants seeking competitive pricing, they can contact their Medicare plan directly.
How can I file a complaint about the quality of care I’ve been receiving from a Medicare provider?
Medicare beneficiaries can file a complaint against a doctor, hospital, provider, drug plan, quality of care and medical equipment. Enrollees can learn how to file a Medicare complaint by contacting their State Health Insurance Assistance Program, or SHIP. Free personalized help will be provided to each Medicare applicant filing a complaint or grievance.
What is the difference between a Medicare network pharmacy and a Medicare preferred network pharmacy?
A Medicare network pharmacy is a pharmacy that a Medicare plan will contract in order to offer prescriptions at a particular price point. Some of these networks will label a pharmacy as preferred within the Network if they offer better benefits or more competitive drug prices.
What do I do if I have been billed for Medicare services that I have never received?
Medicare fraud is an ongoing issue that still seems to plague beneficiaries. If an applicant thinks his or her Medicare account is being fraudulently used, then he or she can call the toll free Medicare number immediately. Applicants can also call the Office of the Inspector General to report Medicare fraud immediately.
What is the Initial Enrollment Period (IEP)?
The Initial Enrollment Period, or IEP, for Medicare is the seven-month period that begins three months before the beneficiary turns 65 years of age (including the birthday month) and ends three months after the beneficiary turns 65 years of age. The seven-month period creates a large window for applicants to seek enrollment before and after their birthday.
Are there specific times when I can sign up for Plan D Medicare coverage?
Yes. Plan D Medicare coverage is available for enrollees during the Initial Enrollment Period or the seven-month period for the Original Medicare program. In conjunction, protective applicants can also sign up for Medicare Part D coverage during the Annual Election Period (AEP), also called the Open Enrollment Period for Medicare.
Can I fast-track my Georgia Medicare appeal?
All Medicare beneficiaries have the opportunity to fast-track their appeal if they disagree with a decision regarding no longer needing services from a nursing home, home health agency or outpatient rehab facility. Applicants can all the State Health Insurance Assistance Program directly for more information.
I have heard the term “donut hole” when used with Medicare Part D. What is this?
The term “donut hole” is a nickname for the Medicare Part D coverage gap, which exists between an applicant and his or her Prescription Drug Plan regarding initial amount covered for prescriptions. Once an applicant reaches his or her initial coverage limit, then he or she ends up in the coverage gap, otherwise known as the “donut hole”.
I’m turning 65 but already have employer insurance coverage. What do I do?
Applicants turning 65 years of age who still have employer health issuance from either a current employer or former employer can decide whether or not to sign up for Medicare coverage. Depending on the size of the employer, applicants can delay their Medicare services without incurring any enrollment penalties.
What is Medicare Supplement Insurance?
Medicare Supplement Insurance, also known as Medigap, is an insurance policy sold by private companies that can help pay certain health care costs that Medicare Part A and Part B will not cover. This includes costs such as coinsurance, copayments and deductibles.
How do I get billed for my Part A and Part D Medicare premiums?
Bills for Medicare Part A and Part B premiums will arrive on a monthly basis in the mail. Also known as the Medicare Monthly Premium Bill, the notification will arrive in the mail around the 10th of the month for services rendered. Instructions to pay the premium bill will be provided on the bill itself.
No. Eligible applicants who meet the Georgia Original Medicare coverage criteria will be able to choose if they will enroll in Medicare Part C and Medicare Part D. Oftentimes, Medicare coverage for eligible enrollees will not include additional services that Part C and Part D offer, such as prescription drugs, vision, hearing and more.
There is no difference between the Medicare Advantage Plan and Medicare Part C. In fact, Medicare Part C is the nickname for the Medicare Advantage Plan. Medicare Plan C offers Medicare-approved private health insurance benefits to approved applicants. Applicants joining the Medicare Advantage Plan are still be in the Medicare program.
The Medicare Extra Help program provides qualified enrollees with an estimated financial addition of nearly $4,000 per year. In order to receive the additional financial benefit, applicants will need to be enrolled in Medicare currently and meet the income and resources requirements.
Unfortunately, applicants cannot leave the Medicare Advantage Program at any time. There is a period called the Medicare Advantage Disenrollment Period, which runs annually from January 1 through February 14. Applicants can leave the program and return to Original Medicare coverage at this time.
For Original Medicare coverage, or Part A and B coverage, approved applicants can find their exact Medicare effective date on the lower right-hand side of their Medicare Card. If applicants do not have their Medicare card handy, then they can reference the letter received from the Social Security Administration.
There is a form that applicants can use called the Authorization to Disclose Personal Health Information that they must fill out and provide directly to Medicare. This form is used to let Medicare know of the person or persons chosen to receive personal health information.
All applicants who chose not to represent themselves during a Georgia Medicare appeal can appoint someone on their behalf. Simply fill out the Appointment of Representative form and send it to the same location where the appeal was sent. If additional help is needed, then applicants can contact their Medicare provider.
What Health Services Are Available in Georgia?
From Obamacare health insurance plans to Medicaid and Medicare, there are various types of health coverage available in Georgia. Each type of insurance can be accessed through a different application method. To learn about the easiest ways to apply for affordable health care in GA, download our comprehensive guide on health services.
Who Is Eligible for Affordable Health Services in Georgia?
Affordable and free health services are often limited to Georgia residents who meet all established eligibility requirements. Income, age and household size are often key factors taken into consideration when determining an applicant’s qualifications. Discover if you qualify for free or reduced-cost health insurance by reviewing the in-depth information on all program eligibility requirements within our comprehensive guide.