CMS funds the Georgia Primary Care Association under the Affordable Care Act as part of national efforts to assist and educate eligible consumers with selecting a health care plan. Navigator duties include:

  • Maintain expertise in eligibility, enrollment, and program specifications,
  • Conduct public education activities to raise awareness about the Exchange,
  • Provide information and services in a fair, accurate, and impartial manner. Such information must acknowledge other health programs (such as Medicaid and the Children’s Health Insurance Program (CHIP)),
  • Facilitate selection of a Qualified Health Plan,
    • Provide referrals to any applicable office of health insurance consumer assistance or health insurance ombudsman established under Section 2793 of the Public Health Service Act, or any other appropriate state agency or agencies, for any enrollee with a grievance, complaint, or question regarding their health plan, coverage, or a determination under such plan or coverage,
  • Provide information in a manner that is culturally and linguistically appropriate to the needs of the population being served by the Exchange, including individuals with limited English proficiency, and ensure accessibility and usability of Navigator tools, such as fact sheets, and functions for individuals with disabilities in accordance with the Americans with Disabilities Act and Section 504 of the Rehabilitation Act.

elder-care

If you have a question about health insurance options, please complete this form. We will be in touch shortly.

    Medicare Open Enrollment

    Medicare Application formThe time to review and compare plans is October 15–December 7.
    During this time, you should:
    Consider costs, coverage, and provider choice.
    Find the best plan for you.

    To explore more information, visit Medicare.gov or the Medicare Plan Finder at: Medicare.gov/plan-compare.
    Or call 1-800-MEDICARE (1-800-633-4227): You can say “Agent” at any time to talk to a customer service representative; Available 24 hours a day, 7 days a week. Support is offered in over 250 languages.

    The Medicare.gov website allows users to compare Medicare health and drug plan options including:

    • Medicare Advantage Plans
    • Medicare drug plans
    • Medicare Supplement Insurance (Medigap) policies

    In addition, Medicare.gov/plan-compare provides detailed information on coverage, costs, and benefits of different plan options in your area based on your prescriptions.

    There is also a website: https://www.shiphelp.org/, which provides free health insurance counseling programs for people with Medicare and their families. The website is funded through federal grants to states. Call 1-800-MEDICARE (1-800-633-4227) .

    Inflation Reduction Act

    If you have Medicare and take insulin (about 3 million people):

    You will pay no more than $35 for a one-month supply of each covered insulin

    For Medicare drug plans (Medicare Part D), the change is effective January 1, 2023

    For Medicare Part B (if you’re medically required to take insulin through a pump that’s considered durable medical equipment (DME)), the change is effective July 1, 2023

    You won’t have to pay a deductible (if your plan has one) with respect to the covered insulin

    People with Medicare who take insulin are encouraged to get help when comparing plans this Open Enrollment Period. Call 1-800 MEDICARE (1-800-633-4227)

    The Health Insurance Marketplace

    In the federally-facilitated Marketplace, the Open Enrollment Period is November 1 – January 15

    In most cases, coverage can begin as soon as January 1, if you enroll by December 15

    Through a single application, you can apply for:

    • Medicaid and the Children’s Health Insurance Program (CHIP)
    • A Marketplace plan.
    • Premium tax credits (which can reduce what you pay for a Marketplace plan)
    • Cost sharing reductions (which are discounts that lower your out-of-pocket costs for deductibles, coinsurance, and copayments).
    • You can apply online, by phone, by mail, or in person
    • Once eligibility is determined, you be able to enroll immediately in most cases.

    Marketplace Call Center:
    Helps you in federally-facilitated Marketplaces (FFMs) and State-based Marketplaces (SPMs):
    1-800-318-2596 (TTY: 1-855-889-4325)
    Customer service representatives are available 24/7
    Help with eligibility, enrollment, and referrals
    Assistance in English and Spanish
    Oral interpretations in 240+ additional languages

    You can apply for Marketplace coverage through:
    HealthCare.gov (English) and CuidadoDeSalud.gov (Spanish)
    Directly through some Marketplace plan issuers
    The Marketplace Call Center
    Marketplace enrollment assisters
    Marketplace-registered agents and brokers, or web-broker sites
    Paper application