Georgia Medicare Disenrollment and Trial Rights: Complete Guide

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Georgia Medicare Disenrollment and Trial Rights: How to Leave Medicare Advantage and Return to Original Medicare With Guaranteed-Issue Medigap

By Brevy Care Team · Last verified May 13, 2026

One of the most underused features of Medicare law is the right to leave Medicare Advantage. Many Georgia beneficiaries who join Medicare Advantage at age 65 assume they are locked in for life, particularly because Medigap (Medicare Supplement) insurance sold outside protected windows is subject to medical underwriting that can deny coverage or impose much higher premiums. The federal framework actually provides several powerful tools to disenroll from MA and return to Original Medicare with guaranteed access to Medigap, without medical underwriting. The most important: the Medicare Advantage Open Enrollment Period (MA OEP) under Section 1851(e)(2)(C)(iii) of the Social Security Act and 42 CFR 422.62(a)(3), which runs January 1 through March 31 each year and allows one switch from MA to Original Medicare or to a different MA plan. The 12-month Medigap trial right under Section 1882(s)(3)(B)(v) and 42 CFR 411.408, which gives beneficiaries who joined MA at first Medicare eligibility (age 65) and disenroll within 12 months guaranteed-issue access to specific Medigap plans without medical underwriting. The 5-Star Special Enrollment Period under 42 CFR 422.62(b)(15) allowing one switch into a 5-star plan between December 8 and November 30. And Special Election Periods under 42 CFR 422.62(b) for qualifying events like moves, loss of employer coverage, plan termination, dual-eligible status changes, and chronic condition diagnosis. This guide explains every disenrollment pathway, the 12-month trial right in detail, what the beneficiary loses by disenrolling, what they gain, the Part D considerations, and worked examples for typical Georgia disenrollment scenarios. :::

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Key takeaways

• MA Open Enrollment Period (MA OEP): Section 1851(e)(2)(C)(iii) SSA and 42 CFR 422.62(a)(3). Runs January 1 through March 31 each year. Allows one switch from MA to Original Medicare or to a different MA plan.
• 12-month Medigap trial right: Section 1882(s)(3)(B)(v) SSA and 42 CFR 411.408. Beneficiaries who joined MA at first Medicare eligibility and disenroll within 12 months have guaranteed-issue Medigap access without medical underwriting.
• 5-Star Special Enrollment Period: 42 CFR 422.62(b)(15). Any beneficiary may use it once between December 8 and November 30 to switch INTO a 5-star plan.
• Special Election Periods: 42 CFR 422.62(b). Available for moves, loss of employer coverage, plan termination, dual-eligible changes, chronic condition diagnosis (C-SNP), facility entry/exit (I-SNP), and other qualifying events.
• Trial right Scenario A: First MA at first Medicare eligibility, disenroll within 12 months. Guaranteed-issue access to ANY Medigap plan in the state.
• Trial right Scenario B: Dropped Medigap to try MA for the first time, disenroll within 12 months. Guaranteed-issue access to the prior Medigap plan, OR Plans A, B, C, F, K, or L from any insurer.
• Window timing: 60 days before MA disenrollment OR 63 days after = the protected window for Medigap application.
• MACRA 2015 phaseout: Plans C and F are NOT available to new Medicare-eligible (post-1/1/2020) beneficiaries; this affects trial right scope.
• Cost trade-off: MA often $0 premium with supplemental benefits; returning to Original Medicare + Medigap + Part D adds monthly costs but provides predictable cost-sharing and broader access.
• Brevy at brevy.com helps Georgia families navigate the disenrollment decision and the Medigap trial right. :::

Federal authority: Section 1851(e) MA election periods and Section 1882(s) Medigap guaranteed issue

Two parallel federal statutes govern Medicare Advantage disenrollment and the protected pathway back to Original Medicare with Medigap.

The first is Section 1851(e) of the Social Security Act, which defines all Medicare Advantage election periods:

• Section 1851(e)(1): Initial Coverage Election Period (ICEP), the 7-month window around first Medicare eligibility
• Section 1851(e)(2)(A): Annual Election Period (AEP), October 15 through December 7 each year
• Section 1851(e)(2)(C)(iii): Medicare Advantage Open Enrollment Period (MA OEP), January 1 through March 31 each year
• Section 1851(e)(4): Special Election Periods for qualifying events

The MA OEP was substantially strengthened by Section 50301 of the Bipartisan Budget Act of 2018 (Public Law 115-123). Under current law, any beneficiary enrolled in a Medicare Advantage plan on January 1 may make one switch during the MA OEP: to a different MA plan, to Original Medicare with a standalone Part D plan, or to Original Medicare without Part D. The MA OEP cannot be used to switch from Original Medicare to MA (that requires AEP, ICEP, or a qualifying SEP).

The second statute is Section 1882(s) of the Social Security Act, which governs Medigap guaranteed-issue rights. Section 1882(s) provides several pathways for Georgia beneficiaries to obtain Medigap without medical underwriting:

• Section 1882(s)(1): The initial 6-month Medigap open enrollment period beginning the month a beneficiary is age 65 and enrolled in Part B
• Section 1882(s)(3)(A): Loss of employer or union group coverage
• Section 1882(s)(3)(B)(i)-(iv): Various MA disenrollment scenarios (plan termination, service area exit, fraud/misrepresentation, involuntary loss of MA coverage)
• Section 1882(s)(3)(B)(v): The 12-month Medigap trial right (the critical protection)
• Section 1882(s)(3)(C): PACE disenrollment
• Section 1882(s)(3)(D)-(E): Medicare Select policy area changes and other scenarios

The implementing regulation is 42 CFR 411.408, which specifies the 63-day window for guaranteed-issue Medigap enrollment following a triggering event.

For Georgia, federal law sets the minimum guaranteed-issue protections. Georgia has not adopted additional state-specific Medigap guaranteed-issue rules beyond the federal floor (some states like Connecticut, Maine, Massachusetts, and New York provide year-round guaranteed issue; Georgia does not).

The Medicare Advantage Open Enrollment Period (MA OEP)

The MA OEP is the most flexible disenrollment window under federal law.

Window

January 1 through March 31 each year.

Who is eligible

Anyone enrolled in a Medicare Advantage plan on January 1 of the year. Beneficiaries in Original Medicare on January 1 cannot use the MA OEP (they must use AEP, ICEP, or a qualifying SEP to switch into MA).

What the MA OEP allows

One change during the window:

• Switch from MA to a different MA plan (with or without prescription drug coverage)
• Switch from MA-PD to Original Medicare with a standalone Part D plan
• Switch from MA-only to Original Medicare with a Part D plan added
• Switch from MA-only to Original Medicare without Part D

What the MA OEP does NOT allow

• Switch from Original Medicare to Medicare Advantage (requires AEP, ICEP, or SEP)
• Multiple changes during the window (only one switch allowed)
• Add Part D when starting from Original Medicare (the beneficiary must currently be in MA)

Effective dates

The change is effective the first day of the month following the request:

• Request January 15 → February 1 effective
• Request February 20 → March 1 effective
• Request March 25 → April 1 effective

Strategic uses

The MA OEP is particularly valuable when:

• A beneficiary tried a new MA plan during AEP and regrets the choice in the first quarter
• The MA plan dropped a key provider from network
• A specialist is needed and the MA HMO requires referrals or denies prior auth
• The plan's Part D formulary doesn't cover a critical medication
• The beneficiary wants to return to Original Medicare for travel flexibility or specialist access

The 12-month Medigap trial right (Section 1882(s)(3)(B)(v))

The trial right is one of the most powerful and least-known protections in Medicare law.

What it does

If a beneficiary meets one of two trial scenarios, they have guaranteed-issue access to specific Medigap plans without medical underwriting when disenrolling from Medicare Advantage. "Guaranteed issue" means:

• No medical underwriting (no health questions)
• No exclusion of pre-existing conditions
• No higher premium based on health status
• Insurer MUST accept the application if filed within the protected window

Scenario A: First MA at first Medicare eligibility

A beneficiary qualifies under Scenario A if:

1. Their first MA plan was their first plan after becoming Medicare-eligible
2. They enrolled in MA during their Initial Coverage Election Period (ICEP)
3. They disenroll from that MA plan within 12 months of the effective date

What they get: Guaranteed-issue access to ANY Medigap plan available in their state.

In Georgia, this means access to Medigap Plans A, B, D, G, K, L, M, N, plus high-deductible variants. (Plans C and F are NOT available to beneficiaries newly eligible for Medicare on or after January 1, 2020 under MACRA 2015. Beneficiaries first eligible before 1/1/2020 still have access to Plans C and F.)

Scenario B: Dropped Medigap to try MA

A beneficiary qualifies under Scenario B if:

1. They had a Medigap policy and a Part D plan
2. They dropped Medigap to enroll in Medicare Advantage for the first time
3. They disenroll from MA within 12 months of the effective date

What they get: Guaranteed-issue access to the SAME Medigap plan they previously had from any insurer (not just the prior insurer), OR Plans A, B, C, F, K, or L from any insurer.

Plans C and F remain available under Scenario B even after the MACRA 2015 phaseout because Scenario B specifically protects beneficiaries who previously had these plans.

The 60-day pre / 63-day post window

To exercise the trial right, the beneficiary must apply for Medigap within a protected window:

• Up to 60 days BEFORE the MA disenrollment effective date, OR
• Up to 63 days AFTER the MA disenrollment effective date

If application is filed within this window, the insurer must issue on guaranteed-issue terms. Outside the window, the insurer may medically underwrite.

Documentation required

To exercise the trial right, the beneficiary provides the Medigap insurer with:

For Scenario A:

• Proof of MA enrollment showing the plan started at first Medicare eligibility (a CMS welcome letter, plan welcome letter, or Social Security enrollment confirmation)
• Proof of MA disenrollment date (a plan disenrollment letter or CMS letter)

For Scenario B:

• Documentation of the prior Medigap policy (insurer policy number, dates of coverage)
• Proof of MA enrollment showing the plan was the beneficiary's first MA
• Proof of MA disenrollment date

Once-per-lifetime per scenario

The trial right can be used once per scenario per lifetime. A beneficiary who used Scenario A in 2025 cannot use it again. They could use Scenario B in the future if they buy a Medigap policy and later drop it to try MA again.

The 5-Star Special Enrollment Period

Under 42 CFR 422.62(b)(15), any Medicare beneficiary may use the 5-Star SEP to enroll in a 5-star MA or Part D contract once during the window December 8 through November 30 each year. The SEP only allows switching INTO a 5-star plan; it cannot be used to switch OUT of one.

For Georgia, the most consistent 5-star MA option historically has been Kaiser Foundation Health Plan of Georgia Senior Advantage in metro Atlanta. Outside metro Atlanta, 5-star MA contract availability has been limited.

The 5-Star SEP is not technically a "disenrollment right" since it requires moving to another plan, not back to Original Medicare. But it serves the same practical purpose for beneficiaries unhappy with their current MA plan: a mid-year escape route into a high-quality alternative.

Special Election Periods (SEPs)

Under Section 1851(e)(4) and 42 CFR 422.62(b), many qualifying events open Special Election Periods. The most relevant for disenrollment scenarios:

Move out of service area

42 CFR 422.62(b)(2): If you move outside your MA plan's service area, you have a 2-month SEP to enroll in a different plan or return to Original Medicare. This SEP also triggers Section 1882(s)(3)(B)(ii) guaranteed-issue Medigap for Plans A, B, C, F, K, L, M, or N.

Loss of employer or union coverage

42 CFR 422.62(b)(2) and 42 CFR 411.408 trigger SEPs and guaranteed-issue Medigap if you lose employer or union retiree health coverage. Particularly relevant for Georgia federal retirees losing FEHB or Georgia State Health Benefit Plan retirees.

Plan termination or sanctions

42 CFR 422.62(b)(4): If CMS terminates an MA plan (e.g., due to low Star Ratings under 42 CFR 422.510), affected enrollees receive an SEP and guaranteed-issue Medigap rights under Section 1882(s)(3)(B)(i).

Dual-eligible status changes

42 CFR 422.62(b)(6): Beneficiaries who become dually eligible, lose Medicaid, or experience LIS status changes have an SEP to switch plans.

Chronic condition diagnosis (C-SNP)

42 CFR 422.62(b)(3): Newly diagnosed with a C-SNP qualifying chronic condition opens a 2-month SEP to enroll in a C-SNP.

LTC facility entry or exit (I-SNP)

42 CFR 422.62(b)(5): Entering or leaving a long-term care facility triggers an SEP for I-SNP eligibility changes.

Other Section 1882(s)(3) guaranteed-issue scenarios

Beyond the trial right and the SEPs, additional Medigap guaranteed-issue rights exist:

Plan involuntarily terminated by CMS

If your MA plan's contract is terminated by CMS (e.g., due to chronic low Star Ratings under 42 CFR 422.510), you have guaranteed issue under Section 1882(s)(3)(B)(i) for Plans A, B, C, F, K, L, M, or N.

Plan misrepresentation or fraud

If you leave an MA plan because of plan misrepresentation, fraud, or violation of marketing rules, guaranteed issue applies.

Move outside service area

Already mentioned: Section 1882(s)(3)(B)(ii). Guaranteed issue for plans available in the new area.

Loss of employer or union retiree coverage

Section 1882(s)(3)(A). Particularly important for federal retirees, Georgia public employees, and other employer retiree plan participants.

Disenrollment from PACE

Section 1882(s)(3)(C). PACE (Program of All-Inclusive Care for the Elderly) disenrollment triggers guaranteed issue.

What you lose by disenrolling from MA

Before exercising disenrollment rights, beneficiaries should understand the trade-offs.

Loss of MA supplemental benefits

Original Medicare with Medigap does not include:

• Dental, vision, hearing
• Fitness benefits (SilverSneakers)
• OTC allowances
• SSBCI categories (food cards, transportation, pest control, etc.)
• Wellness programs and care management

For beneficiaries who heavily use MA dental and vision, this can be a significant loss. They may consider standalone dental, vision, and hearing plans, which exist but add to monthly out-of-pocket costs.

Possible loss of $0 premium

Many MA plans have $0 monthly premium (the Part C cost is fully absorbed by federal capitation). Original Medicare with Medigap typically costs:

• Part B premium: $202.90 per month standard (2026); higher with IRMAA
• Medigap Plan G: varies by age, gender, tobacco use, and county in Georgia
• Part D: approximately $46.50 per month (2026 national average)

Total varies based on Medigap plan selection. Compare to MA, which often has $0 plan premium (plus the Part B premium, which everyone pays regardless of coverage type).

Loss of out-of-pocket maximum

MA plans have a federally mandated annual out-of-pocket maximum: $9,250 in 2026 for in-network services. Original Medicare alone has NO out-of-pocket maximum, which is the central reason Medigap is critical when returning to Original Medicare.

Loss of care coordination

MA plans, especially SNPs and HMOs, provide care coordination through PCP gatekeepers, care managers, and prior authorization workflows. Original Medicare is unmanaged fee-for-service; the beneficiary navigates care independently.

What you gain by disenrolling from MA

Provider choice

Original Medicare accepts care from any provider that accepts Medicare. No network restrictions. Particularly valuable for beneficiaries who travel, want to see specialists at academic medical centers, or live in areas with narrow MA networks.

No prior authorization (mostly)

Original Medicare has minimal prior authorization, limited to specific services like inpatient rehab and some DME. MA plans have extensive prior authorization under 42 CFR 422.138 (though the January 2026 reforms reduced prior auth burden).

Predictable cost-sharing with Medigap

Medigap Plan G covers all Medicare cost-sharing except the Part B deductible ($283 in 2026). After paying the monthly premium and the annual Part B deductible, you typically owe nothing for Medicare-covered services. Compare to MA copays that vary and can accumulate throughout the year.

Specialist access without referrals

HMO MA plans typically require PCP referrals for specialist visits. PPO MA plans don't, but charge higher out-of-network cost-sharing. Original Medicare allows direct specialist access.

Travel coverage

Original Medicare covers care anywhere in the United States. MA HMO plans typically cover only emergency care outside their service area. Medigap Plans C, D, F, G, M, and N include limited foreign travel emergency coverage.

Part D considerations

A beneficiary disenrolling from MA-PD to Original Medicare must consider Part D:

1. Enroll in a standalone Part D plan: Most disenrollment SEPs include a Part D enrollment opportunity. Enroll within the SEP window to avoid the Part D Late Enrollment Penalty.

2. OR maintain creditable coverage: Beneficiaries with VA prescription coverage, TRICARE for Life, FEHB, or other creditable coverage can defer Part D without penalty.

3. Document creditable coverage: If you're using VA, TRICARE, FEHB, or employer coverage as your Part D substitute, retain the annual creditable coverage notice to avoid future LEP if you later enroll in Part D.

For more on creditable coverage and the Part D Late Enrollment Penalty, see Brevy's Georgia Medicare Creditable Coverage guide.

Worked examples for Georgia

Example 1: Margaret 67 Atlanta MA OEP switch

Margaret turned 65 in January 2024 and enrolled in a Humana MA-PD plan effective January 1, 2024. During AEP 2025 (October 15 - December 7), she stayed with Humana for plan year 2026. In January 2026, she discovers her PCP dropped out of the Humana network.

She uses MA OEP (January 1 - March 31, 2026) to switch to an Aetna MA-PD plan effective February 1, 2026. She does not return to Original Medicare; she switches MA to MA.

She cannot use the 12-month trial right because (a) Aetna is still a Medicare Advantage plan, not Original Medicare, and (b) she has been in MA for 24+ months, well outside the 12-month window.

Example 2: Robert 65 Savannah Medigap trial right

Robert turned 65 in March 2025. During his ICEP, he enrolled in a Wellcare MA-PD plan effective April 1, 2025. By December 2025 (8 months in), he is frustrated with prior authorization delays and his cardiologist leaving the network. He decides to disenroll.

He uses MA OEP 2026 to disenroll from Wellcare effective February 1, 2026. He returns to Original Medicare.

Within the protected window (60 days before disenrollment + 63 days after), he applies to Mutual of Omaha for Medigap Plan G. He provides documentation:

• His Wellcare welcome letter dated March 2025 showing plan effective April 1, 2025
• His Wellcare disenrollment letter dated January 2026 showing disenrollment effective February 1, 2026
• His SSA Medicare card showing entitlement date of March 2025

Under Section 1882(s)(3)(B)(v) Scenario A (first MA at first Medicare eligibility, disenrolling within 12 months: April 2025 to February 2026 = 10 months), Mutual of Omaha must issue Plan G on guaranteed-issue basis. No medical underwriting, no pre-existing condition exclusion.

Robert also enrolls in a standalone Part D plan effective February 1, 2026 (using the disenrollment-triggered Part D SEP).

His estimated monthly costs:

• Part B premium: $202.90
• Plan G premium: varies by age, gender, and area in Georgia
• Part D: his specific plan premium (2026 national average approximately $46.50/month)

He has no copays for Medicare-covered services except the Part B deductible ($283 once a year).

Example 3: Linda 68 Macon dropped Medigap for MA

Linda had Medigap Plan F (she became Medicare-eligible in 2018, before MACRA 2015's Plan F phaseout) and a separate Part D plan. In May 2025, she dropped Plan F to enroll in a Humana MA-PD plan, attracted by $0 premium and dental coverage. After 8 months, she regrets the decision because she travels frequently and the MA HMO doesn't cover non-emergency care out of state.

She disenrolls during MA OEP 2026 effective February 1, 2026.

Under Section 1882(s)(3)(B)(v) Scenario B (dropped Medigap to try MA), she has guaranteed-issue access to:

• The same Plan F she had previously, from any insurer
• OR Plans A, B, C, F, K, or L from any insurer

She applies to Mutual of Omaha for Plan F (her prior plan) with documentation of her prior Plan F policy plus her Humana MA enrollment and disenrollment letters. Mutual of Omaha issues Plan F on guaranteed-issue basis.

Linda also re-enrolls in a standalone Part D plan effective February 1, 2026.

Example 4: Charles 72 Augusta no Scenario A but has Scenario B

Charles turned 65 in 2019. He enrolled in Original Medicare with Medigap Plan G at that time and kept that arrangement until 2025. In October 2025, attracted by $0 premium MA dental benefits, he dropped his Medigap and enrolled in a UnitedHealthcare MA-PD plan effective January 1, 2026.

By March 2026 (3 months in), Charles is frustrated with the MA plan's prior authorization for his diabetes medications. He uses MA OEP to disenroll effective April 1, 2026.

Does he have a trial right?

• Scenario A: Required first MA at first Medicare eligibility. Charles's first plan was Original Medicare + Medigap in 2019, not MA. NOT eligible for Scenario A.
• Scenario B: Required dropping Medigap to try MA for the first time. Charles dropped Plan G in October 2025 to try MA in January 2026. He is disenrolling within 12 months. Eligible for Scenario B.

Under Scenario B, Charles has guaranteed-issue access to:

• Plan G (his prior plan) from any insurer, OR
• Plans A, B, C, F, K, or L from any insurer

He applies to AARP/UnitedHealthcare (different from his prior Plan G insurer, but allowed under Scenario B) for Plan G with documentation. He is issued on guaranteed-issue basis.

He also enrolls in standalone Part D.

Example 5: Patricia 65 Columbus too late for trial right

Patricia turned 65 in January 2025 and enrolled in a Humana MA-PD plan effective February 1, 2025. By March 2026 (13 months in), she is frustrated and wants to leave.

She uses MA OEP March 2026 to disenroll effective April 1, 2026.

Does she have a trial right?

• Scenario A: Required disenrollment within 12 months. Patricia's 12-month window expired February 1, 2026. NOT eligible. She missed the trial right by approximately one month.

She can return to Original Medicare, but Medigap insurers in Georgia may medically underwrite her application. If she has diabetes, hypertension, or other conditions, she may face higher premiums or even denial.

The lesson: The 12-month trial right window runs from the MA effective date, not from the calendar year. Beneficiaries who joined MA at age 65 and are considering disenrollment should set a calendar reminder for month 10 or 11 to evaluate whether to act within the protected window.

What can Patricia do?

1. Apply for Medigap and hope she passes underwriting
2. Stay in MA and re-evaluate during AEP 2026 for plan year 2027
3. Switch to a different MA plan during MA OEP rather than returning to Original Medicare
4. If she has a qualifying event (move, employer coverage loss), use that SEP to trigger Medigap guaranteed issue

Example 6: Henry 73 Athens leaves MA via 5-Star SEP

Henry is enrolled in a 2.5-star MA plan and is frustrated by prior authorization delays. In April 2026, he discovers Kaiser Senior Advantage achieved a 5-star rating in the October 2025 release and is available in his Athens ZIP code (assume Kaiser expanded service area).

He uses the 5-Star SEP (42 CFR 422.62(b)(15)) to switch from his 2.5-star plan to Kaiser Senior Advantage effective May 1, 2026. He does NOT return to Original Medicare; he switches MA to MA.

The 5-Star SEP can be used only once per window (December 8 through November 30). Henry's window for plan year 2026 ratings is December 8, 2025 through November 30, 2026. He has used his SEP for the year.

This example illustrates that the 5-Star SEP is a "switch into" tool, not a disenrollment tool. To leave Medicare Advantage entirely, Henry would need to wait for MA OEP, AEP, or a qualifying SEP.

Common mistakes to avoid

1. Believing MA enrollment is permanent. Multiple disenrollment pathways exist. You are not locked in.

2. Missing the 12-month trial right window. The window runs from the MA effective date, not from the calendar year. Mark month 10 or 11 to evaluate.

3. Assuming MA OEP allows multiple switches. Only one switch per OEP. Use it wisely.

4. Trying to use MA OEP to leave Original Medicare. The MA OEP only applies to current MA enrollees. To switch from Original Medicare to MA, use AEP, ICEP, or a qualifying SEP.

5. Disenrolling from MA-PD without enrolling in standalone Part D. Creates Part D Late Enrollment Penalty exposure. Either enroll in Part D during the same window or document creditable coverage.

6. Believing all Medigap plans are available under trial right. Newly eligible (post-1/1/2020) beneficiaries cannot get Plans C and F under Scenario A. They remain available under Scenario B for beneficiaries who previously had them.

7. Confusing trial right scenarios A and B. Scenario A requires first MA at first Medicare eligibility; Scenario B requires having dropped a prior Medigap to try MA. Different qualification rules.

8. Not documenting trial right eligibility when applying for Medigap. Insurers may erroneously underwrite if you don't proactively document. Bring your CMS letters and prior policy documents.

9. Believing the trial right requires MA OEP for disenrollment. The disenrollment can happen during AEP, MA OEP, or any qualifying SEP. The trial right protection runs from the disenrollment, not from the OEP.

10. Missing the 63-day post-disenrollment window for Medigap. Apply within 63 days of MA disenrollment effective date or you lose the guaranteed-issue protection.

11. Not understanding that Medigap doesn't include drug coverage. You must enroll separately in Part D to avoid the LEP and to have prescription coverage.

12. Assuming Georgia has extra state Medigap protections. Georgia follows federal minimum guaranteed-issue rules; no state extension.

13. Believing MA termination by CMS always provides trial right protection. Plan termination triggers Section 1882(s)(3)(B)(i) guaranteed issue (Plans A, B, C, F, K, L, M, N), which is different from the Section 1882(s)(3)(B)(v) trial right.

14. Not understanding the cost trade-off. MA often $0 premium with supplemental benefits; Original Medicare + Medigap + Part D adds meaningful monthly costs (Part B + Medigap + Part D). Run the numbers on your specific situation.

Frequently asked questions

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What is the Medicare Advantage Open Enrollment Period?

The MA OEP, codified at Section 1851(e)(2)(C)(iii) SSA and 42 CFR 422.62(a)(3), runs January 1 through March 31 each year. Any current MA enrollee may use it to make one change: switch to a different MA plan, switch to Original Medicare with Part D, or switch to Original Medicare without Part D.

Can I use MA OEP to switch from Original Medicare to Medicare Advantage?

No. The MA OEP only applies to current MA enrollees. To switch from Original Medicare to MA, use the Annual Election Period (October 15 - December 7), your Initial Coverage Election Period at age 65, or a qualifying Special Election Period.

What is the Medigap trial right?

Section 1882(s)(3)(B)(v) SSA and 42 CFR 411.408 give Medicare beneficiaries who joined MA at first eligibility (or who dropped Medigap to try MA) guaranteed-issue access to specific Medigap plans if they disenroll within 12 months of their MA effective date. No medical underwriting, no pre-existing condition exclusions.

How long does the trial right last?

12 months from the MA enrollment effective date. The window is strict. A beneficiary who joined MA on April 1, 2025 must disenroll by April 1, 2026 to qualify. The 63-day Medigap application window runs from the disenrollment date.

What's the difference between Trial Right Scenario A and Scenario B?

Scenario A applies to beneficiaries whose first MA plan was their first plan after Medicare eligibility (no prior Original Medicare period). They get guaranteed access to ANY Medigap plan in their state. Scenario B applies to beneficiaries who had a Medigap policy and dropped it to try MA. They get guaranteed access to the SAME prior Medigap plan from any insurer, OR Plans A, B, C, F, K, or L from any insurer.

Can I use the trial right more than once?

The trial right is once per lifetime per scenario. Scenario A can only be used once (since it requires "first MA at first eligibility"). Scenario B can technically be used multiple times if a beneficiary buys Medigap, drops it for MA, returns to Medigap, drops it again, and so on. But each Scenario B use must follow the 12-month rule.

What if my 12-month trial right has expired?

You can still disenroll from MA at AEP, MA OEP, or any qualifying SEP. But Medigap insurers in Georgia may medically underwrite your application. If you have health conditions, you may face higher premiums or denial. Some other guaranteed-issue scenarios may apply (e.g., if you move out of the MA service area).

Can I keep my Medicare Advantage dental and vision benefits if I return to Original Medicare?

No. MA supplemental benefits (dental, vision, hearing, fitness, OTC, SSBCI) end when you disenroll. You can purchase standalone dental, vision, and hearing plans privately, though costs vary by plan and coverage level.

Do I need a new Part D plan if I disenroll from MA-PD?

Generally yes, unless you have other creditable prescription drug coverage (VA, TRICARE for Life, FEHB, employer retiree plan). Most disenrollment SEPs include a Part D enrollment opportunity. Enroll within the SEP window to avoid the Part D Late Enrollment Penalty.

How much does Original Medicare + Medigap + Part D typically cost?

In Georgia 2026, approximately:

• Part B premium: $202.90 per month (standard, more with IRMAA)
• Medigap Plan G: varies by age, gender, tobacco use, and county in Georgia
• Standalone Part D: approximately $46.50 per month (2026 national average)

Total varies based on Medigap plan and area. Compare to MA, which often has $0 plan premium plus the same $202.90 Part B premium that everyone pays.

Are Plans C and F still available?

Plans C and F are not available to beneficiaries newly Medicare-eligible on or after January 1, 2020 under MACRA 2015. Beneficiaries first eligible before that date can still buy Plans C and F. Under Trial Right Scenario B, beneficiaries who previously had Plan C or F may re-enroll in those plans regardless of when they became Medicare-eligible.

Does Georgia have any extra Medigap protections?

No. Georgia follows the federal minimum guaranteed-issue rules. Other states (Connecticut, Maine, Massachusetts, New York) have stronger protections like year-round guaranteed issue, but Georgia does not.

Can I switch from MA to a 5-star plan mid-year?

Yes, using the 5-Star SEP under 42 CFR 422.62(b)(15). The window runs from December 8 (after Star Ratings release) through November 30 the following year. One use per window. Only switches INTO a 5-star plan (not OUT of one).

What happens if my MA plan is terminated by CMS?

You receive a Special Election Period under 42 CFR 422.62(b)(4) running from the termination notice through the end of the second month after the termination effective date. You also have guaranteed-issue Medigap rights under Section 1882(s)(3)(B)(i) for Plans A, B, C, F, K, L, M, or N.

Can I disenroll from MA if I move?

Yes. A move outside the MA plan's service area triggers an SEP under 42 CFR 422.62(b)(2). You can switch to another MA plan in the new area or return to Original Medicare with guaranteed-issue Medigap rights under Section 1882(s)(3)(B)(ii).

Do I lose Medicaid benefits if I disenroll from a D-SNP?

No. Disenrolling from a D-SNP affects only your Medicare Advantage coverage; your Medicaid eligibility is separate and continues. However, you lose the integration benefits (single ID card, coordinated case management) that the D-SNP provided.

What is the difference between MA OEP and AEP?

AEP (October 15 - December 7) is the Annual Election Period where any beneficiary can enroll in, switch, or disenroll from MA, with new plan effective January 1. MA OEP (January 1 - March 31) is only for current MA enrollees and allows one change to a different MA plan or Original Medicare with new plan effective the first of the following month.

Can I use the trial right if my MA plan was terminated by CMS?

Plan termination triggers a separate guaranteed-issue protection under Section 1882(s)(3)(B)(i) for Plans A, B, C, F, K, L, M, or N. If you also qualify under Scenario A or B trial right, you may have access to additional Medigap plans.

Are pre-existing conditions covered under guaranteed-issue Medigap?

Yes, generally. Federal law requires Medigap insurers issuing on guaranteed-issue basis to cover pre-existing conditions immediately if the beneficiary had at least 6 months of continuous prior creditable coverage. Most beneficiaries qualify, since MA enrollment counts as creditable coverage.

Can I switch back to MA after disenrolling?

Yes, during AEP, ICEP (if still in window), or a qualifying SEP. Disenrolling does not permanently bar future MA enrollment.

How do I know if my MA plan starting date is right for the trial right?

The trial right runs from your MA effective date, not from your enrollment request date. Effective date is the first day of the month MA coverage began (typically the month after enrollment request for MA OEP/AEP enrollments, or the first day of Medicare entitlement for ICEP enrollments). Check your CMS welcome letter or plan welcome packet.

What if the Medigap insurer denies me coverage despite a trial right?

This should not happen if you provide proper documentation within the protected window. If it does, file a complaint with the Georgia Department of Insurance (1-800-656-2298). Contact Medicare Rights Center (1-800-333-4114) or Center for Medicare Advocacy (1-860-456-7790) for advocacy support.

Where can I get help deciding whether to disenroll from MA?

GeorgiaCares SHIP (1-866-552-4464) provides free Medicare counseling on disenrollment decisions, Medigap selection, and Part D considerations. Their counselors are trained on the federal trial right framework.

Does Brevy help with disenrollment decisions?

Yes. Brevy at brevy.com offers guides on Medicare Advantage, Medigap, the 12-month trial right, MA OEP timing, Part D considerations, and how to evaluate whether disenrollment is right for your specific situation in Georgia. :::

Get help with Medicare disenrollment and Medigap

The decision to leave Medicare Advantage and return to Original Medicare with Medigap involves trade-offs of cost, benefits, and care access. Free counseling is available to help Georgia beneficiaries make informed decisions and exercise their trial rights.

::: cta

Georgia Medicare disenrollment and Medigap resources

Medicare and federal resources

• Medicare: 1-800-MEDICARE (1-800-633-4227); 24/7 disenrollment processing and Medigap questions
• Medicare Plan Finder: medicare.gov/plan-compare; compare MA and Part D plans
• Social Security Administration: 1-800-772-1213; Medicare entitlement records
• Medicare Rights Center: 1-800-333-4114; free national Medicare counseling and advocacy
• Center for Medicare Advocacy: 1-860-456-7790; appeals and trial right enforcement
• Justice in Aging: 202-289-6976; policy and beneficiary protection advocacy

Georgia counseling and oversight

• GeorgiaCares (Georgia SHIP): 1-866-552-4464; free disenrollment and Medigap counseling statewide
• Georgia Department of Insurance: 1-800-656-2298; Medigap insurer complaints and consumer protection
• Georgia Department of Community Health Medicaid Member Services: 1-866-211-0950; for dually eligible disenrollments
• Georgia Aging and Disability Resource Connection: 1-866-552-4464; aging services
• Eldercare Locator: 1-800-677-1116; local Georgia Area Agencies on Aging

Legal assistance for Georgia seniors

• Atlanta Legal Aid Senior Citizens Law Project: 404-377-0701; free legal help for low-income seniors in metro Atlanta
• Georgia Legal Services Program: 1-800-498-9469; free legal help for low-income Georgians outside metro Atlanta
• AARP Georgia: 1-866-295-7277; advocacy and member resources

Information resources

• Brevy: brevy.com; eldercare guides on MA, Medigap, trial rights, and Part D
• 211 Georgia: dial 211; community resource referrals
• National Council on Aging BenefitsCheckUp: benefitscheckup.org; comprehensive benefit screening

Brevy is committed to helping Georgia families understand Medicare Advantage disenrollment, the 12-month Medigap trial right, the MA OEP and other election periods, Special Election Periods triggered by qualifying events, and the trade-offs of returning to Original Medicare with Medigap. Visit brevy.com for more guides on Medicare in Georgia, or call 1-866-552-4464 for free counseling from GeorgiaCares.

Find personalized help navigating Medicare disenrollment and Medigap trial rights at brevy.com.

Disclaimer: This guide explains federal Medicare Advantage disenrollment rules under Section 1851(e) of the Social Security Act and Medigap guaranteed-issue protections under Section 1882(s) of the Social Security Act, with implementing regulations at 42 CFR 422.62 and 42 CFR 411.408 as of May 2026. The 12-month trial right window is calculated from the MA effective date. Medigap plan availability, pricing, and underwriting rules vary by insurer and may change. This is general educational information, not Medicare or Medigap enrollment advice. Always verify your specific eligibility with Medicare, your Medigap insurer, or a Georgia SHIP counselor before making disenrollment decisions. :::