Georgia Medicare 5-Star Rating Special Enrollment Period (2026)

Between December 8 and November 30 each year, a Georgia Medicare beneficiary can move into a 5-star-rated Medicare Advantage or Part D plan one time, outside fall Open Enrollment. That window is the Georgia Medicare 5-Star Special Enrollment Period (5-Star SEP), the only enrollment path Medicare ties to plan quality instead of a life event.1

In This Guide

• How the Georgia Medicare 5-Star Special Enrollment Period Works
• Who Qualifies for the Medicare 5-Star Special Enrollment Period in Georgia
• What You Can Switch Into
• How to Use the 5-Star SEP in Georgia
• The 5-Star SEP vs Other Enrollment Windows
• 5-Star Plans in Georgia
• Three Georgia Scenarios
• Frequently Asked Questions
• Where to Get Help in Georgia
• Learn More

How the Georgia Medicare 5-Star Special Enrollment Period Works

The 5-Star SEP lets you switch from your current Medicare plan into a 5.0-star Medicare Advantage plan, a Medicare Advantage Prescription Drug (MA-PD) plan, or a standalone Part D drug plan. You can use it one time between December 8 of the year before the plan year and November 30 of the plan year, and the change takes effect the first of the month after you enroll.2 No moving, no lost coverage, and no other qualifying life event is required; the trigger is the plan's CMS Star Rating.1

The authority sits in Section 1851(e)(4) of the Social Security Act for Medicare Advantage and in the enrollment regulations at 42 CFR 422.62 (Medicare Advantage) and 42 CFR 423.38 (Part D). Those rules set the December 8 to November 30 window, the once-per-cycle limit, and the 5.0-star eligibility requirement.

CMS publishes new Star Ratings each October for the following contract year, rating each plan on a 1-to-5 scale from quality and performance measures.1 A plan that earns 5.0 stars in October becomes 5-Star SEP eligible when the new ratings take effect on January 1; a plan that falls below 5.0 loses that eligibility the same way. Star Ratings do not change mid-year, so a rating is fixed for the whole contract year.

Who Qualifies for the Medicare 5-Star Special Enrollment Period in Georgia

You can use the 5-Star SEP if all four of these are true.1

If a 5.0-star plan does not serve your Georgia county, the 5-Star SEP cannot help you this year; you would change plans during fall Open Enrollment or another Special Enrollment Period instead.

What You Can Switch Into

The 5-Star SEP is a switch into a 5.0-star plan. When you enroll, the new plan disenrolls you from your old one automatically, effective the first of the following month, so you do not cancel the prior plan yourself. These are the moves it supports:

Switching from Medicare Advantage back to Original Medicare and a 5-star Part D plan does not, by itself, give you a guaranteed right to buy a Medigap policy. Georgia follows the federal rule, so outside a guaranteed-issue window a Medigap insurer can use medical underwriting. Confirm your Medigap options before you drop Medicare Advantage.

How to Use the 5-Star SEP in Georgia

The 5-Star SEP vs Other Enrollment Windows

The 5-Star SEP is one of several ways to change Medicare coverage, and it stacks on top of the others rather than replacing them. Using it does not use up your fall Open Enrollment or Medicare Advantage Open Enrollment change.3

Fall Open Enrollment, running October 15 to December 7, is the broad window for any change, taking effect January 1. Medicare Advantage Open Enrollment, January 1 to March 31, lets someone already in a Medicare Advantage plan make one change.3 Beneficiaries who get Extra Help or are dually eligible for Medicaid have a separate monthly SEP to change a standalone Part D plan, a right that became a once-per-month election on January 1, 2025 under CMS rule CMS-4205-F.4 Only the 5-Star SEP turns on plan quality; the rest turn on your circumstances.

5-Star Plans in Georgia

Georgia is a heavy Medicare Advantage state. As of March 2026, CMS counted 2,016,427 people with Medicare in Georgia, of whom 1,132,147 were enrolled in Medicare Advantage and other health plans and 884,280 stayed in Original Medicare. That puts more than half the state's beneficiaries in a private plan. CMS also reports that 100% of people with Medicare in Georgia have access to a Medicare Advantage plan with a $0 monthly premium for 2026.5 For 2026, CMS awarded 5.0 stars to 18 Medicare contracts nationwide, up from 7 a year earlier, so 5-star plans exist but are not offered in every market.1

CMS reports 180 Medicare Advantage plans available in Georgia for 2026, up from 178 in 2025. Read that as a statewide count, not a menu for your county: KFF's analysis of the same CMS landscape files, counting only plans open to general enrollment, finds the average Georgia beneficiary chooses among 47 plans offered by an average of 8 insurers.5 Those are market totals, not current 5-star plans: which specific contracts hold a 5.0-star rating changes every October, so always confirm a plan's current rating on Medicare Plan Finder before assuming it qualifies for the 5-Star SEP.

Availability skews toward the metros. Atlanta-area counties (Fulton, DeKalb, Cobb, Gwinnett) tend to see the most 5-star options, while rural South Georgia counties may have few or none. Every 4-star and 5-star plan shares in the quality bonus payments authorized under Section 1853(o) of the Social Security Act, but only a 5.0-star plan unlocks the year-round 5-Star SEP.

Watch for misleading marketing. A plan or agent may claim a 5-star rating it does not hold, or push a Special Enrollment Period you do not qualify for. Verify any rating yourself on Plan Finder, and report suspected fraud to the Georgia Senior Medicare Patrol, reachable through GeorgiaCares at 1-866-552-4464, or review the plan against the CMS marketing rules.

Three Georgia Scenarios

Scenario 1: a mid-year switch in Fulton County. Margaret is in a 4-star Medicare Advantage plan in Atlanta. In June she finds a 5.0-star plan with the dental coverage she now needs. A GeorgiaCares SHIP counselor confirms the plan's current rating, that it serves Fulton County, that she has not used the SEP this cycle, and that her doctors are in network. She enrolls through the 5-Star SEP effective July 1, and her old plan ends automatically.

Scenario 2: weighing the 5-Star SEP against MA Open Enrollment. James, in DeKalb County, is unhappy with his 4-star plan in February because his specialist left the network. He has two paths: Medicare Advantage Open Enrollment (any MA plan, through March 31) or the 5-Star SEP (5.0-star plans only). None of the county's 5-star plans include his specialist, so he uses MA Open Enrollment to move to a 4.5-star plan that does, preserving his 5-Star SEP for later in the year.

Scenario 3: a rural county with no 5-star plan. Linda lives in Worth County in rural South Georgia and wants out of her 3.5-star plan. A GeorgiaCares SHIP counselor checks current ratings and finds no 5-star Medicare Advantage plan serving Worth County, so the 5-Star SEP cannot help her for a Medicare Advantage switch. She decides to compare options at fall Open Enrollment instead.

These scenarios are hypothetical illustrations.

Where to Get Help in Georgia

Learn More

Find personalized help comparing 5-star Medicare plans and using the 5-Star SEP at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.