24 Best Medicare Part D Plans in Georgia for 2023

We found the 24 best Medicare Part D Plans in Georgia for 2023.

We also ranked the best Medicare Advantage plans with Part D in Georgia for 2023.

Georgia Medicare Part D Plans Have Four Phases

Georgia Medicare prescription drug plansMedicare Part D plans are an option Medicare beneficiaries can use to get prescription drug coverage. Part D plans provide cost-sharing on covered medications in four different phases: deductible, initial coverage, coverage gap, and catastrophic. Each... help beneficiaries pay for their prescription medications. If you are new to Medicare, some of the Part D plan concepts may be foreign to you. So we'll start with an overview of the four cost-sharing phases.

Phase 1 is the Deductible

A Medicare Part D plan's deductible is the amount you pay out-of-pocket before the initial coverage phase begins and the plan begins paying its share. So, if you enroll in a plan with a $225 deductible, you'll spend that much at the pharmacy for your prescriptions. After that amount, you will pay the copayA copayment, also known as a copay, is a set dollar amount you are required to pay for a medical service. amount only until you reach the coverage gapA period of time in which you pay higher cost-sharing for prescription drugs until you spend enough to qualify for catastrophic coverage.. Most Medicare prescription drug plans have a deductible, however, many plans exclude Tier 1 drugs from the deductible, which gives you first-dollar coverage on most lower-cost medications.

NOTE: The maximum Part D plan deductible in 2023 is $505.

Phase 2 is the Initial Coverage Limit

The 2023 Initial Coverage LimitOnce you have met your yearly deductible, you will pay a copayment or coinsurance for each covered drug until you reach the initial coverage limit. You will then enter your plan’s coverage gap (aka, “donut... (ICL) is $4,660. The ICL phase is when your Part D plan begins to pay the bulk of the costs. If your prescription costs exceed $4,660, you will enter the Coverage Gap phase (aka, "donut hole").

The Third Phase is a Coverage Gap

After your gross drug costs have reached $4,660, you will enter the Coverage Gap phase. This is where you will pay 25% of your medication's retail cost. While the price of generic drugsA generic drug is a prescription medication that has the same active ingredient formula as a brand-name drug. Generic drugs usually cost less than brand-name drugs. might not be much different, what you pay for brand-name drugs will be higher (because you're paying 25% of the full price). This will continue until you reach $7,400 in True Out Of Pocket Costs (TrOOP).

Some plans offer additional gap coverage, so look for it on the plan information pages.

Phase 4 is Catastrophic Coverage

Once you've spent $7,400 out-of-pocket you are out of the coverage gap phase and will receive catastrophic coverage. This happens automatically and ensures that you only pay a small amount for all covered drugs for the remainder of the year.

The out-of-pocket costsOut-of-Pocket Costs for Medicare are the remaining costs that are not covered by the beneficiary's health insurance plan. These costs can come from the beneficiary's monthly premiums, deductibles, coinsurance, and copayments. that help you get catastrophic coverage include:

1. Your plan's deductible;
2. What you paid during the initial coverage limit period;
3. Most of the full cost of brand-name drugs (and the manufacturer’s discount) purchased in the coverage gap;
4. The amount paid by others, including family members, most charities, and other persons on your behalf; and
5. The amount paid by State Pharmaceutical Assistance Programs (SPAPs), AIDS Drug Assistance Programs, and the Indian Health Service.

Choose Your Part D Plan Wisely

Evaluate Part D Medicare plans wisely. If you have a regular prescription or two, we suggest that you verify that the plan you want offers your medication(s) at a good price. You find this information in the formularyA formulary is a list of prescription drugs covered by a prescription drug plan or another insurance plan offering prescription drug benefits. Medications not on a plan's formulary are generally not covered.. We post links to the formulary and pharmacy web pages, as well as the plan's phone number, on each of the PDP pages listed above.

IMPORTANT: Identifying the best Medicare Part D Plans for you takes a bit of research. What's best for you is personal and must consider multiple factors, including your regular prescriptions, your health, and your finances.

Medicare Part D is Included in Most Medicare Advantage Plans

Medicare realizes that one type of plan does not suit everyone. That's why there are two ways to get help with your prescription drug costs. All of the Medicare prescription drug plans available in Georgia work with Original MedicareOriginal Medicare is private fee-for-service health insurance for people on Medicare. It has two parts. Part A is hospital coverage. Part B is medical coverage.. That's one way to get coverage. But maybe you'd like even more benefits. That's where Georgia Medicare Advantage Plans come in. Most offer Part D coverage.

Medicare Part D and Medicare Supplements Work Together

Are you thinking about supplemental Medicare insurance that can offer you more coverage? It's a smart move. Original Medicare only covers about 80 percent of your major medical bills, leaving you to cover the rest. We make it easy to find the lowest rates on Georgia Medicare Supplements, also known as Medigap plans. The choice is yours because all Part D plans are compatible with the full range of Georgia Medicare SupplementsMedicare Supplements are additional insurance policies that Medicare beneficiaries can purchase to cover the gaps in their Original Medicare (Medicare Part A and Medicare Part B) health insurance coverage..

Georgia Medicaid and Your Medicare Part D

If you meet the requirements for both Medicare and Medicaid (aka, "dual eligible" or "Medi-Medi") in Georgia, you will automatically receive a Medicare Prescription Drug Plan, as well as Extra Help from Social Security. If you qualify for Extra Help, the program will cover most of the costs of your prescriptions. Even if you qualify, the dual eligible option may not suit your needs. In this case, enroll in the prescription drug plan of your choice. If you receive MedicaidMedicaid is a public health insurance program that provides health care coverage to low-income families and individuals in the United States. now, call your local Medicaid office for assistance with your dual eligible benefits.

Citations & References

1. Medicare.gov, "How Medicare Prescription Drug Coverage Works with a Medicare Advantage Plan or Medicare Cost Plan", Last Accessed September 28, 2022
2. Medicare.gov, "How Part D works with other insurance", Last Accessed July 14, 2022
3. Medicare.gov, "Medicare costs at a glance", Last Accessed September 11, 2022
4. Medicare.gov, "Are prescription drugs covered in Medicare Advantage plans?", Last Accessed June 5, 2022
5. SSA.gov, "Extra Help with Medicare Prescription Drug Plan Costs", Last Accessed June 1, 2022
6. CMS.gov, "Landscape Source Files", Last Accessed January 15, 2023
7. CMS.gov, "Medicare Part C & D Performance", Last Accessed January 15, 2023

This Medicare Part D plan state information page was last updated on January 19, 2023.