Georgia Medigap: Medicare Supplement Insurance Plans and Open Enrollment

::: hero

By Brevy Care Team · Last verified May 13, 2026

Medicare Supplement Insurance, known as Medigap, is the most popular way for Original Medicare beneficiaries in Georgia to manage the substantial cost-sharing that Parts A and B leave behind. A 7-day hospital stay carries a $1,736 Part A deductible in 2026, a routine specialist visit comes with a 20 percent coinsurance after the $283 annual Part B deductible, and a hospitalization followed by 30 days in a skilled nursing facility can cost a beneficiary nearly $8,000 in out-of-pocket cost-sharing. Without supplemental coverage, those bills land directly on the beneficiary's household budget.

Federal law under Section 1882 of the Social Security Act (42 USC 1395ss) and 42 CFR 403.205 through 403.272 standardizes Medigap into ten lettered plan types (A, B, C, D, F, G, K, L, M, N) and gives beneficiaries a 6-month guaranteed-issue Open Enrollment Period when carriers cannot use medical underwriting to deny coverage or charge higher premiums based on health status. MACRA 2015 (PL 114-10 Section 401) closed Plan F, Plan C, and High-Deductible Plan F to beneficiaries newly eligible for Medicare on or after January 1, 2020. Plan G has since become the most popular comprehensive plan in Georgia, with Plan N as the leading cost-conscious alternative and High-Deductible Plan G growing rapidly among healthy buyers seeking low monthly costs.

Georgia follows the federal minimum protections without state-level enhancements. Unlike California, Oregon, Washington, Illinois, Idaho, Nevada, and Louisiana, Georgia has no Medigap Birthday Rule and no continuous guaranteed-issue protections for plan switching. This means timing matters enormously: a Georgia beneficiary who enrolls in Medicare Advantage at age 65 and later wants to switch to Original Medicare with a Medigap supplement generally faces medical underwriting unless he uses the 12-month Medicare Advantage trial right under Section 1882(s)(3) or qualifies for another guaranteed-issue triggering event.

This guide covers every aspect of Medigap for Georgia families: the federal standardization framework, the ten lettered plan types and what each covers, the 6-month Open Enrollment Period and the 12-month MA trial right, the MACRA 2015 changes that closed Plan F and Plan C, the Georgia carrier landscape and typical premium ranges, the comparison between Medigap with Original Medicare and Medicare Advantage, the critical interaction with Medicare Savings Programs and full Medicaid (where Medigap is generally unnecessary and prohibited from sale), the SELECT plan provisions, and the consumer protection rules including guaranteed renewability under Section 1882(c)(1)(D) and the prohibition on selling Medigap to Medicare Advantage enrollees under Section 1882(d)(3). We close with six worked examples, fifteen common Medigap mistakes, a comprehensive FAQ, and a contact list for Georgia families. :::

::: callout Federal Authority: Section 1882 of the Social Security Act (42 USC 1395ss), 42 CFR 403.205 through 403.272, and the NAIC Medicare Supplement Insurance Model Regulation

Standardized Plans: A, B, C, D, F, G, K, L, M, N (Plan F and Plan C closed to newly eligible 1/1/2020 per MACRA 2015)

Most Popular Plan in Georgia (newly eligible): Plan G covers everything except the annual Part B deductible ($283 in 2026)

Open Enrollment Period: 6 months starting the first month a beneficiary is BOTH age 65 OR older AND enrolled in Part B. Guaranteed issue with no medical underwriting under Section 1882(s)(2).

Medicare Advantage Trial Right: 12-month guaranteed-issue window under Section 1882(s)(3) for those who enrolled in MA at first Medicare eligibility.

Georgia Resources: Georgia Office of Insurance Commissioner 1-800-656-2298; GeorgiaCares SHIP 1-866-552-4464; Medicare 1-800-MEDICARE :::

The Federal Framework: Section 1882 of the Social Security Act

The statutory foundation of Medigap is Section 1882 of the Social Security Act, codified at 42 USC 1395ss. This section was originally enacted in 1980 under the Baucus Amendment to address widespread fraud and abuse in the unstandardized Medigap market of the 1970s. Section 1882 has been amended substantially over the decades, with the most consequential reforms in OBRA 1990 (PL 101-508), BBA 1997 (PL 105-33), MIPPA 2008 (PL 110-275), and MACRA 2015 (PL 114-10).

The current framework rests on five federal principles:

Standardization (Section 1882(b)(1)(B)). Insurance carriers selling Medigap may only offer plans matching one of the ten federally standardized plan types. The benefits of each plan type are identical across carriers and states (with the exceptions of Massachusetts, Minnesota, and Wisconsin, which have their own standardization systems).

Open Enrollment (Section 1882(s)(2)). Beneficiaries have a 6-month guaranteed-issue window beginning the first month they are both age 65 or older and enrolled in Medicare Part B. During this window, carriers cannot deny coverage, charge higher premiums for health status, or impose pre-existing condition waiting periods (with limited exceptions for those without 6 months of prior creditable coverage).

Medicare Advantage Trial Right (Section 1882(s)(3)). Beneficiaries who enroll in Medicare Advantage at their first Medicare eligibility have a 12-month guaranteed-issue window to disenroll from MA and purchase Medigap. Several additional guaranteed-issue events apply for other circumstances.

Guaranteed Renewability (Section 1882(c)(1)(D)). Once enrolled, Medigap policies must be renewable for the beneficiary's lifetime. Carriers can cancel only for non-payment of premium or material misrepresentation on the application.

Prohibition on Sale to MA Enrollees (Section 1882(d)(3)(A)). It is illegal to sell Medigap to a Medicare Advantage enrollee. This prevents wasteful duplicate coverage.

The NAIC Medicare Supplement Insurance Model Regulation provides the implementation framework that states adopt. Georgia's Medigap law is codified at O.C.G.A. Title 33 Chapter 43 and largely follows the NAIC model with federal minimum protections.

The Ten Standardized Medigap Plans

All Medigap plans must provide the same core benefits: Part A hospital coinsurance plus 365 extra hospital days, Part B coinsurance, first 3 pints of blood, and Part A hospice coinsurance. Plans differ in what additional cost-sharing they cover. Here's each plan's structure as it applies in 2026.

Plan A: Core Benefits Only

Plan A provides only the core benefits described above. It does not cover the Part A deductible, the Part B deductible, the skilled nursing facility coinsurance, or foreign travel emergency. Plan A is rarely sold today because higher-coverage plans are available at modest additional premiums.

Plan B: Plan A Plus Part A Deductible

Plan B adds coverage of the Part A hospital deductible ($1,736 in 2026). This was once a popular budget plan, but Plan G now offers far more coverage at competitive premiums.

Plan C (Closed to Newly Eligible 1/1/2020)

Plan C adds skilled nursing facility coinsurance for days 21 through 100, the Part B deductible, and foreign travel emergency coverage. Plan C is closed to those newly eligible for Medicare on or after January 1, 2020 under MACRA 2015. Beneficiaries already enrolled in Plan C can keep their plans. Those eligible for Medicare before 2020 can still purchase Plan C from carriers that still offer it.

Plan D: Plan C Without Part B Deductible

Plan D provides Plan C benefits except for the Part B deductible. It remains open to newly eligible beneficiaries because it does not cover the Part B deductible (MACRA 2015 only closed plans that covered the Part B deductible).

Plan F (Closed to Newly Eligible 1/1/2020)

Plan F was historically the most comprehensive Medigap plan, covering all Medicare cost-sharing including the Part B deductible and Part B excess charges (15 percent above approved amount when providers don't accept assignment). Plan F is closed to newly eligible beneficiaries under MACRA 2015. High-Deductible Plan F is similarly closed. Existing Plan F enrollees can keep their plans, but the carrier pool is shrinking and premium increases tend to be higher than Plan G because the risk pool is older and not refreshed by new enrollees.

Plan G: The New Most-Popular Plan

Plan G provides all Plan F benefits except the Part B deductible. With newly eligible beneficiaries paying the Part B deductible ($283 in 2026) once per year, Plan G provides nearly comprehensive coverage. Plan G is the market-leading comprehensive Medigap plan in Georgia for those newly eligible after January 1, 2020.

High-Deductible Plan G is also available. Beneficiaries pay a CMS-set annual deductible before the plan's standard Plan G benefits kick in. Monthly premiums are dramatically lower than standard Plan G, making it attractive for healthy beneficiaries with low expected utilization.

Plan K: 50 Percent Coinsurance Plan

Plan K covers 50 percent of most cost-sharing (Part A coinsurance after the first 60 days, Part B coinsurance after deductible, SNF coinsurance, Part A deductible, Part B blood) and 100 percent of Part B coinsurance after the beneficiary reaches an annual out-of-pocket limit (indexed annually by CMS). Plan K offers lower premiums in exchange for higher cost-sharing.

Plan L: 75 Percent Coinsurance Plan

Plan L covers 75 percent of the same cost-sharing categories as Plan K and 100 percent of Part B coinsurance after a lower annual out-of-pocket limit than Plan K (indexed annually by CMS). Plan L has lower premiums than standard Plan G but higher cost-sharing.

Plan M: 50 Percent Part A Deductible

Plan M provides Plan D benefits except covers only 50 percent of the Part A deductible. It is rarely sold in Georgia.

Plan N: Office and ER Copays

Plan N provides Plan D benefits except adds a $20 office visit copay and a $50 emergency room copay (waived if admitted). Plan N also does not cover Part B excess charges. Plan N offers premium savings of 15 to 25 percent compared to Plan G, making it the second most popular plan for cost-conscious buyers in Georgia.

What Plan G Pays (The Reference Plan)

Plan G has become the de facto reference plan for Georgia beneficiaries newly eligible for Medicare. Here is what Plan G covers in 2026:

Part A Coverage

• Hospital deductible: $1,736 covered after the beneficiary first pays nothing because Plan G covers the deductible
• Hospital coinsurance days 61-90: $434/day covered
• Lifetime reserve days 91-150: $868/day covered
• Hospital coverage beyond 150 days: Plan G provides 365 additional days
• Skilled nursing facility coinsurance days 21-100: $217/day covered
• Part A hospice coinsurance: covered
• First 3 pints of blood: covered

Part B Coverage

• Annual deductible: $283 (beneficiary pays, not covered by Plan G)
• Coinsurance: 20 percent of Medicare-approved amount (covered by Plan G)
• Part B excess charges: 15 percent above approved amount (covered by Plan G)

Foreign Travel Emergency

• 80 percent of emergency care costs incurred outside the US during the first 60 days of travel
• $50,000 lifetime maximum
• $250 deductible

What Plan G Does NOT Cover

• Part B deductible ($283 in 2026) is paid by the beneficiary once per year
• Part D prescription drugs (separate Part D plan required)
• Vision, dental, hearing aids, long-term care (not Medicare benefits)
• Cost-sharing for services not covered by Medicare

Medigap Open Enrollment Period

The Medigap Open Enrollment Period (OEP) is the single most important consumer protection in the Medigap framework. Under Section 1882(s)(2) of the Social Security Act, the OEP is a 6-month window beginning the first month a beneficiary is both age 65 or older and enrolled in Medicare Part B.

Guaranteed Issue During OEP

During the OEP, insurance carriers must:

1. Issue any Medigap plan they sell to the beneficiary regardless of health status
2. Charge the same premium they would charge a healthy person of the same age
3. Not impose pre-existing condition waiting periods if the beneficiary had at least 6 months of prior creditable coverage
4. Not cancel or refuse to renew coverage once issued

Pre-Existing Condition Limitation Exception

Carriers may impose up to a 6-month pre-existing condition exclusion. The exclusion is waived if the beneficiary had at least 6 months of prior creditable coverage. Most beneficiaries transitioning from employer health insurance or Medicaid have sufficient creditable coverage to waive the waiting period.

Calculating the OEP

The OEP begins the first month the beneficiary is both:

• Age 65 or older
• Enrolled in Medicare Part B

For most beneficiaries, this is the month they turn 65 (assuming they enroll in Part B during their Initial Enrollment Period).

For a beneficiary who delays Part B enrollment past 65 (for example, because of active employment group health coverage), the OEP begins when Part B coverage actually starts, not when the beneficiary turns 65.

Critical Importance for Georgia

Georgia follows the federal minimum 6-month OEP without state extension. Unlike California (Birthday Rule), Oregon, Washington, Illinois, Idaho, Nevada, and Louisiana (all with various continuous guaranteed-issue protections), Georgia beneficiaries who miss the OEP face medical underwriting if they later apply for Medigap. Carriers can deny coverage or charge significantly higher premiums based on health conditions.

This makes the OEP a once-in-a-lifetime opportunity for most Georgia beneficiaries. The decision made during this 6-month window largely determines lifetime supplemental insurance access and cost.

Medicare Advantage Trial Right

For Georgia beneficiaries who initially chose Medicare Advantage at first eligibility, Section 1882(s)(3) of the Social Security Act provides a critical second chance: the 12-month Medicare Advantage trial right.

How It Works

Beneficiaries who enrolled in Medicare Advantage at their first Medicare eligibility (during the Initial Coverage Election Period aligned with their IEP) have 12 months to:

1. Disenroll from the MA plan
2. Return to Original Medicare
3. Purchase any Medigap plan with guaranteed issue from any carrier in their service area
4. Avoid medical underwriting

Why This Matters in Georgia

Medicare Advantage is heavily marketed in Georgia, particularly to first-time enrollees. Many Georgia seniors choose MA at age 65 based on $0 premium marketing and extra benefits like dental and vision. Some later discover MA limitations:

• Network restrictions limit provider choice
• Prior authorization requirements delay care
• Specialist referrals required in HMO plans
• Out-of-pocket maximums can still reach $9,250 in 2026

The 12-month trial right provides an escape valve. Without it, beneficiaries who chose MA initially and want to switch later would face medical underwriting in Georgia, often resulting in higher premiums or denial.

Other Guaranteed Issue Events

Section 1882(s)(3) also provides 63-day guaranteed-issue windows for:

• Moving outside the MA plan service area
• MA plan termination by the carrier or CMS
• Employer group health plan termination
• MA plan reduction or termination of geographic coverage
• Loss of trial right MA plan during a second trial right

Federal Standardization and Why It Matters

Federal standardization under Section 1882(b)(1)(B) means that Plan G from Carrier A provides identical benefits to Plan G from Carrier B. The plans cannot differ in what they cover. This dramatically simplifies shopping because comparison is purely on:

1. Premium
2. Rate adjustment methodology (attained-age, issue-age, or community-rated)
3. Premium history (how the carrier has increased rates over time)
4. Carrier financial stability and customer service reputation
5. Additional services (24-hour nurse lines, fitness programs, etc.)

Beneficiaries should never pay attention to "plan benefits" beyond the standardized definition because the benefits cannot legally differ. Beneficiaries should focus entirely on price, rate stability, and carrier quality.

Guaranteed Renewability

Under Section 1882(c)(1)(D), once enrolled, a Medigap plan must be guaranteed renewable for the beneficiary's lifetime. Carriers cannot:

• Cancel coverage based on health status
• Refuse to renew based on claims experience
• Cancel based on age
• Cancel based on the development of new health conditions after enrollment

Carriers can cancel only for:

• Non-payment of premium
• Material misrepresentation on the application
• Discontinuation of an entire plan type (with prior notice and replacement coverage rights)

Guaranteed renewability is what makes Medigap meaningfully different from many private insurance products. Once a beneficiary is enrolled, his coverage is secure regardless of how his health changes.

Prohibition on Selling Medigap to MA Enrollees

Section 1882(d)(3)(A) makes it illegal for any person to sell or issue a Medigap policy to a Medicare Advantage enrollee. The prohibition prevents wasteful duplicate coverage because Medigap does not pay for any services covered by Medicare Advantage.

Civil Penalties

The Federal civil penalty under Section 1882(d)(3) is up to $25,000 per violation. Georgia's Office of Insurance Commissioner can also impose state penalties and revoke licenses of brokers who violate the prohibition.

Exception

The sole exception is the 63-day window before MA enrollment ends. During this window, a beneficiary planning to disenroll from MA can purchase Medigap with the coverage timed to begin when MA coverage ends.

Practical Implications

Beneficiaries enrolled in Medicare Advantage who want Medigap must first disenroll from MA, return to Original Medicare, and then purchase Medigap. Outside of guaranteed-issue periods, this typically means medical underwriting.

SELECT Plans

Section 1882(t) authorizes Medigap SELECT plans, which use a preferred provider network. Beneficiaries enrolled in a SELECT plan must use network providers for full benefits (with emergency exceptions). In exchange, SELECT plan premiums are typically 10 to 20 percent lower than equivalent non-SELECT plans.

SELECT plans are less common in Georgia than in some other states. Beneficiaries considering SELECT plans should verify:

• Network adequacy in their geographic area
• Network providers acceptance of new Medicare patients
• Out-of-network coverage gaps
• Switching options if they move or providers leave the network

Georgia Carrier Landscape and Premium Ranges

Major Medigap carriers active in Georgia include AARP UnitedHealthcare, Anthem Blue Cross Blue Shield of Georgia, Cigna, Humana, Mutual of Omaha, Aetna, Bankers Fidelity, Continental Life, Manhattan Life, and Lumico. Premiums vary by:

• Plan type
• Beneficiary age
• Geographic area
• Tobacco use
• Carrier underwriting philosophy
• Rate adjustment methodology

Typical 2026 Premium Ranges

Georgia premiums track closely with national medians. Nationally, Plan G premiums for a 65-year-old non-smoker run approximately $150–$175/month; Plan N runs approximately $125–$150/month. High-Deductible Plan G carries significantly lower premiums. Actual quotes vary by carrier, age, geographic area, and tobacco use. Use Medicare.gov's Medigap policy search tool or contact GeorgiaCares SHIP for current Georgia carrier quotes.

Premiums shift based on metropolitan area, age (premiums rise with age under attained-age methodology), and tobacco use (typically 10-20 percent surcharge for tobacco users).

Rate Adjustment Methodologies

Attained-age: Premium increases with the beneficiary's current age. Most common in Georgia. Initial premiums are lower, but the premium climbs as the beneficiary ages.

Issue-age: Premium is based on the beneficiary's age at enrollment and does not increase with age (only with general inflation and class rate increases). Initial premiums are higher, but the long-term path is more stable.

Community-rated: Premium does not vary by age. Rare in Georgia.

Household Discounts

Many carriers offer 5 to 12 percent household discounts when both spouses (or members of a household) enroll. Some offer additional discounts for EFT payment or annual payment.

Medigap and Original Medicare versus Medicare Advantage

Georgia beneficiaries face an annual decision: stick with Original Medicare plus Medigap plus Part D, or enroll in Medicare Advantage. Here's the comparison.

Original Medicare + Medigap + Part D

Advantages:

• Any Medicare provider nationwide accepts the coverage
• Minimal prior authorization
• Predictable cost-sharing (Medigap fills most gaps)
• Best for snowbirds, travelers, and those wanting full provider choice
• Best for those with high or specialized health needs

Disadvantages:

• Higher monthly premium cost (Medigap premium plus separate Part D plan premium)
• Pay annual Part B deductible ($283 in 2026, except Plan F/C grandfathered)
• No additional benefits like dental, vision, hearing aids

Typical monthly cost in Atlanta: Part B premium $202.90 + Plan G (nationally ~$150–$175/month for age 65 non-smoker) + Part D (varies by plan)

Medicare Advantage

Advantages:

• Often $0 premium beyond Part B
• Frequently includes Part D, dental, vision, hearing benefits
• Annual maximum out-of-pocket limit
• All-in-one plan with predictable cost-sharing

Disadvantages:

• Network restrictions (HMO most restrictive, PPO with reduced out-of-network benefits)
• Prior authorization common, particularly for specialty care
• Specialist referrals required in HMO plans
• Out-of-network costs can be high
• Some plans require approval for hospitalization

Typical monthly cost in Atlanta: Part B premium $202.90 + MA plan $0-$30 = approximately $202.90-$221.50/month, plus copays per service

How to Choose

The choice depends on:

• Health status: Medigap better for those with high utilization or chronic conditions; MA can work for healthy beneficiaries who use few services
• Travel patterns: Medigap better for snowbirds and frequent travelers; MA networks generally regional
• Provider preferences: Medigap better for those wanting to keep specific providers, especially specialists
• Cost tolerance: MA better for low monthly cost; Medigap better for predictable annual costs
• Risk tolerance: Medigap minimizes financial uncertainty; MA caps annual exposure but with more complexity

GeorgiaCares SHIP counselors can help beneficiaries work through this decision based on individual circumstances.

Interaction with Medicare Savings Programs and Full Medicaid

This is one of the most critical and least understood aspects of Medigap for Georgia families. The interaction depends on which Medicare-Medicaid coordination program the beneficiary qualifies for.

Full Medicaid Plus QMB

Beneficiaries with full Georgia Medicaid plus Qualified Medicare Beneficiary status do NOT need Medigap. Medicaid covers all Medicare cost-sharing, and Section 1902(n)(3)(B) of the Social Security Act prohibits Medicare providers from billing QMB enrollees for any cost-sharing.

Buying Medigap as a QMB enrollee is generally wasteful because:

• Medicare cost-sharing is already paid by Medicaid (or prohibited from billing)
• Medigap premium is an out-of-pocket cost with no benefit
• Section 1882(d)(3) prohibits brokers from selling Medigap to dual-eligibles with full Medicaid

QMB-Only (Without Full Medicaid)

Beneficiaries with QMB but not full Medicaid still have their Part A and Part B premiums and cost-sharing covered by QMB. They generally do NOT need Medigap because the federal prohibition on billing QMB enrollees still applies.

SLMB and QI

SLMB (Specified Low Income Medicare Beneficiary) and QI (Qualifying Individual) pay only the Part B premium. They do NOT pay Medicare cost-sharing (deductibles, coinsurance, copayments). Beneficiaries with SLMB or QI remain responsible for all Medicare cost-sharing, and Medigap CAN be useful for them.

However, premium affordability is a key issue. SLMB and QI enrollees have low to moderate incomes (typically under 135 percent FPL). Adding a $160/month Plan G premium may be difficult to fit into a fixed budget.

Working with a Broker

Georgia families should:

• Disclose Medicaid eligibility upfront when shopping for Medigap
• Verify that the broker is licensed by Georgia Office of Insurance Commissioner
• Report any broker who attempts to sell Medigap to a dual-eligible with full Medicaid (this is a violation)
• Use GeorgiaCares SHIP for unbiased guidance before purchasing

Worked Examples

Margaret 65 Atlanta: Plan G During Open Enrollment

Margaret retired from her teaching career in Atlanta at age 65 in October 2025. She enrolled in Medicare Part A and Part B during her IEP, with coverage effective October 1, 2025. Her 6-month Medigap OEP runs October 2025 through March 2026.

Margaret meets with a GeorgiaCares counselor in November. The counselor explains:

• Plan G is the most comprehensive plan available to her (Plan F closed in 2020)
• She should shop multiple carriers because Plan G is federally standardized (same benefits everywhere)
• Within OEP, no underwriting, no health questions
• Compare premium, rate methodology, and rate history

Margaret compares quotes:

• AARP UnitedHealthcare Plan G: $172/month (attained-age)
• Anthem BCBS Georgia Plan G: $165/month (attained-age)
• Mutual of Omaha Plan G: $158/month (attained-age)
• Cigna Plan G: $185/month (attained-age)
• Aetna Plan G: $179/month (attained-age)

She also reviews each carrier's rate history. Mutual of Omaha and Anthem have moderate annual increases (5-7%). Some others have higher historical increases.

Margaret chooses Mutual of Omaha Plan G at $158/month. Coverage effective November 1, 2025. No underwriting, no waiting period. Her total Medicare costs:

• Part B premium: $202.90/month
• Plan G: $158/month
• Part D: $32/month
• Total: $381.50/month

Robert 70 Savannah: Late Underwriting Denial

Robert turned 65 in March 2020 and enrolled in Original Medicare. He was healthy at the time and decided to skip Medigap to save money. He paid out-of-pocket for occasional doctor visits and assumed he would purchase Medigap later "if needed."

Five years later, in 2025, Robert is diagnosed with Type 2 diabetes and hypertension. He realizes Medicare cost-sharing is becoming a financial burden and decides to apply for Plan G.

Robert is outside his OEP (which ended in September 2020). Georgia does not provide a Birthday Rule or continuous guaranteed issue. He must go through medical underwriting.

Robert applies to multiple carriers:

• AARP UnitedHealthcare: declined due to recent diabetes diagnosis
• Mutual of Omaha: approved but at health-rated premium of $325/month (instead of $185 standard)
• Cigna: declined due to combination of diabetes and hypertension
• Aetna: approved at $295/month

Robert reluctantly enrolls in Mutual of Omaha at $325/month, paying $140/month more than he would have during OEP. The decision to skip Medigap during OEP costs him approximately $1,680/year for the rest of his life.

Linda 67 Macon: MA Trial Right

Linda turned 65 in May 2025. Aggressively marketed Medicare Advantage materials in the mail and visits from local brokers led her to enroll in a Medicare Advantage HMO at first eligibility. The plan had a $0 premium, included Part D, and offered dental, vision, and hearing benefits.

After 8 months on the MA plan, Linda is increasingly frustrated:

• Her preferred cardiologist is out of network
• She needs prior authorization for a specialty medication and waits 30 days
• A referral process for orthopedic care adds delays
• Out-of-network costs are $4,200 for one visit she could not avoid

Linda contacts GeorgiaCares. The counselor identifies that Linda enrolled in MA at first Medicare eligibility, so she qualifies for the 12-month MA trial right under Section 1882(s)(3).

Linda has 4 months remaining in her trial right window. She:

1. Disenrolls from the MA plan effective end of month 9
2. Enrolls in standalone Part D plan
3. Applies for Plan G with guaranteed issue (no underwriting required due to MA trial right)
4. Multiple carriers must accept her at standard rates

Linda chooses Anthem BCBS Georgia Plan G at $168/month. Her total monthly Medicare costs:

• Part B premium: $202.90
• Plan G: $168
• Part D: $38
• Total: $397.50/month

While higher monthly than her MA plan, Linda now has provider choice, no prior auth for most services, and predictable cost-sharing.

Charles 75 Augusta: Plan N for Premium Savings

Charles has been enrolled in standard Plan G for 10 years. His current premium is $185/month after several years of increases. He reviews his utilization:

• 4 PCP visits/year
• 2 specialist visits/year
• Annual labs and imaging
• One ER visit in past 3 years

Charles considers switching to Plan N for $40/month savings. He calculates the cost difference:

• Plan G annual: $185 x 12 = $2,220 (no copays)
• Plan N annual: $145 x 12 = $1,740 plus 6 office visits at $20 = $1,860
• Annual savings: $360

He's outside OEP, so Plan N switching requires underwriting in Georgia. He has been healthy with no major conditions in the past 5 years. He applies during his birthday month (he doesn't get a Birthday Rule in Georgia, but he chooses this timing for budgeting reasons).

Carriers approve Charles for Plan N at standard rates. He switches to Anthem BCBS Georgia Plan N at $145/month. He saves $360/year on premium while paying $80/year in office copays (net savings $280/year).

Patricia 68 Columbus: High-Deductible Plan G

Patricia is healthy with low utilization. She visits her PCP twice per year and has annual labs but no specialist visits. She wants to minimize her monthly Medicare costs while maintaining catastrophic protection.

She compares standard Plan G ($162/month) with High-Deductible Plan G ($48/month, with a CMS-set annual deductible):

Standard Plan G annual cost:

• Premium: $162 x 12 = $1,944
• Out-of-pocket: $0 (except $283 Part B deductible)
• Total maximum exposure: ~$2,200

High-Deductible Plan G annual cost (assuming low utilization):

• Premium: $48 x 12 = $576
• Out-of-pocket: $0-$400 typical year
• Total typical: $576-$976

High-Deductible Plan G annual cost (assuming worst case — full deductible reached):

• Premium: $48 x 12 = $576
• Out-of-pocket: Full CMS-set deductible plus $283 Part B deductible
• Total worst case: higher than standard Plan G in a major-illness year

Patricia chooses High-Deductible Plan G because:

• Her typical year cost is approximately $976 vs. $2,200 for standard Plan G (saving over $1,200)
• Her monthly premium savings significantly outweigh expected annual utilization
• Over 10 years of typical utilization, premium savings compound substantially

Henry 73 Athens: QMB-Plus Declines Medigap

Henry is full-Medicaid plus QMB. His income is $1,100/month from Social Security and a small annuity. He receives unsolicited mail from a local insurance broker advertising "Medicare Supplement Plans starting at $89/month" with claims about "filling all your Medicare gaps."

Henry calls the broker, who arranges a home visit. The broker recommends Plan G at $185/month and warns Henry that "without Medigap, you'll be stuck with thousands in medical bills."

Henry visits GeorgiaCares before committing. The counselor explains:

• Henry has full Medicaid plus QMB status
• Section 1902(n)(3)(B) of the Social Security Act prohibits Medicare providers from billing him for any Medicare cost-sharing
• Georgia Medicaid pays his Part A and Part B premiums through Section 1843 Buy-In
• Georgia Medicaid covers any Medicare cost-sharing the providers might try to charge
• Medigap would duplicate coverage he already has at no cost
• Section 1882(d)(3) prohibits brokers from selling Medigap to dual-eligibles with full Medicaid

Henry declines the Medigap policy. The counselor also helps Henry report the broker to Georgia Office of Insurance Commissioner. The broker is investigated for targeting dual-eligibles in violation of federal and state law.

Henry saves $185/month ($2,220/year) by avoiding an unnecessary purchase.

15 Common Medigap Mistakes

1. Missing the 6-month Open Enrollment Period. Georgia provides only federal minimum protections. After OEP, medical underwriting applies and beneficiaries with health conditions can be denied or face surcharged premiums.

2. Assuming all Medigap plans are the same. The ten standardized plan types differ significantly in what cost-sharing they cover. Plan A covers only core benefits; Plan G covers nearly everything except Part B deductible.

3. Buying Plan F when newly eligible after 1/1/2020. Plan F is closed under MACRA 2015. If a broker offers Plan F to someone newly eligible after 2020, that broker is mistaken or fraudulent.

4. Buying Medigap while enrolled in Medicare Advantage. This is prohibited under Section 1882(d)(3) with up to $25,000 federal civil penalties per violation.

5. Buying Medigap while having full Medicaid plus QMB. Wasteful and prohibited from sale. Medicaid already covers all Medicare cost-sharing.

6. Not understanding the Medicare Advantage trial right. 12 months under Section 1882(s)(3) for those who enrolled in MA at first eligibility. This is a critical second chance to switch to Original Medicare + Medigap.

7. Failing to compare premiums across carriers. Same plan, dramatically different prices. Plan G premiums vary widely from carrier to carrier for the same beneficiary — always compare at least 3–4 quotes.

8. Confusing Medigap with Part D. Medigap does not cover prescription drugs and has not since 2006 (Plan H, I, J were retired). Beneficiaries need a separate Part D plan.

9. Choosing a plan based only on premium without considering coverage. Plan K and Plan L have lower premiums but require beneficiary cost-sharing up to annual out-of-pocket limits.

10. Not understanding rate adjustment methodology. Attained-age plans get more expensive with age. Issue-age plans start higher but stay relatively stable. Most Georgia plans are attained-age.

11. Letting premiums lapse. Guaranteed renewability applies as long as premiums are paid. A lapsed policy can be cancelled and re-enrolling requires going through underwriting outside OEP.

12. Buying Medigap from unlicensed agents. Verify with Georgia Office of Insurance Commissioner (1-800-656-2298) that the agent is licensed.

13. Believing Medigap covers long-term care. It does not. Medigap covers Medicare cost-sharing only, not custodial care, nursing home long-stays, or assisted living.

14. Believing Medigap covers vision, dental, or hearing aids. It does not. These are not Medicare benefits and are not covered by Medigap.

15. Not exploring Medicare Savings Programs that might eliminate the need for Medigap. QMB enrollment eliminates most of the rationale for Medigap. Low-income beneficiaries should check QMB eligibility before purchasing Medigap.

Quick Reference

Standardized Plans: A, B, C, D, F, G, K, L, M, N (Plan F and Plan C closed to newly eligible 1/1/2020) Most Popular Plan (newly eligible): Plan G Most Popular Cost-Conscious Plan: Plan N Open Enrollment Period: 6 months starting first month age 65+ AND enrolled in Part B MA Trial Right: 12 months for those who enrolled in MA at first eligibility Georgia OEP Extension: None (federal minimum only) Georgia Birthday Rule: None Plan G Premium Range: Nationally ~$150–$175/month (65 yo non-smoker); get Georgia quotes via GeorgiaCares or Medicare.gov High-Deductible Plan G Deductible: Set annually by CMS; contact GeorgiaCares or visit Medicare.gov for current figures Carriers Active in Georgia: AARP UHC, Anthem BCBS, Cigna, Humana, Mutual of Omaha, Aetna, others

::: accordion

What is Medigap?

Medigap is Medicare Supplement Insurance, a private insurance product designed to fill the cost-sharing gaps in Original Medicare Parts A and B. Under Section 1882 of the Social Security Act, Medigap plans are federally standardized into ten lettered plan types (A, B, C, D, F, G, K, L, M, N).

What does Medigap cover?

Medigap covers some or all of the cost-sharing left by Original Medicare: Part A hospital deductible, Part A coinsurance, Part B coinsurance, skilled nursing facility coinsurance, foreign travel emergency, and (depending on the plan) the Part B deductible and Part B excess charges. Each plan type has a defined benefit structure.

When can I enroll in Medigap?

Your 6-month Medigap Open Enrollment Period under Section 1882(s)(2) begins the first month you are both age 65 or older AND enrolled in Medicare Part B. During this window, carriers must issue you any plan they sell regardless of health status.

What happens if I miss the Open Enrollment Period?

Georgia provides only federal minimum protections. After OEP, carriers can use medical underwriting to deny coverage, charge higher premiums, or impose pre-existing condition waiting periods. Some Georgia beneficiaries are denied Medigap entirely after OEP.

Does Georgia have a Medigap Birthday Rule?

No. Unlike California, Oregon, Washington, Illinois, Idaho, Nevada, and Louisiana, Georgia does not have a Medigap Birthday Rule or continuous guaranteed-issue protections. Once OEP ends, switching plans requires underwriting.

Why is Plan F closed?

MACRA 2015 (PL 114-10 Section 401) closed Plan F, Plan C, and High-Deductible Plan F to those newly eligible for Medicare on or after January 1, 2020. The change was designed to require beneficiaries to share in Part B deductible costs. Plan F remains available to those eligible for Medicare before 2020, and existing Plan F enrollees can keep their plans.

Should I get Plan G or Plan N?

Plan G is more comprehensive but has higher premium. Plan N has lower premium but includes a $20 office visit copay and $50 ER copay (waived if admitted). Plan N is better for cost-conscious buyers with low utilization. Plan G is better for those who want minimal out-of-pocket exposure.

What is High-Deductible Plan G?

High-Deductible Plan G has a CMS-set annual deductible but dramatically lower monthly premium than standard Plan G. After the deductible is met, standard Plan G benefits apply. Best for healthy beneficiaries with low expected utilization.

Can I switch Medigap plans?

Yes, but in Georgia switching plans outside OEP typically requires medical underwriting. Carriers can deny coverage or charge higher premiums based on health status. You can switch carriers within the same plan type (e.g., Plan G to Plan G with a different carrier) but still face underwriting if outside OEP.

Are all Medigap Plan G policies the same?

The benefits are identical because of federal standardization under Section 1882(b)(1)(B). What varies is premium, rate adjustment methodology, customer service, and additional services. Shop on price and carrier quality, not benefits.

Can I have both Medigap and Medicare Advantage?

No. Section 1882(d)(3)(A) prohibits selling Medigap to Medicare Advantage enrollees. You must be in Original Medicare to use Medigap.

Should I get Medigap if I have Medicaid?

Generally no, especially if you have full Medicaid plus QMB. Medicaid covers all Medicare cost-sharing, making Medigap redundant. Selling Medigap to dual-eligibles with full Medicaid is prohibited under Section 1882(d)(3). SLMB and QI enrollees may benefit from Medigap if income permits, but premium affordability is often an issue.

How much does Medigap cost in Georgia?

Nationally, Plan G premiums for a 65-year-old non-smoker run approximately $150–$175/month; Plan N approximately $125–$150/month. High-Deductible Plan G is significantly lower. Premiums vary by carrier, age, location, and tobacco use — contact GeorgiaCares SHIP or use Medicare.gov for current Georgia quotes.

What is the Medicare Advantage trial right?

Under Section 1882(s)(3), if you enrolled in Medicare Advantage at your first Medicare eligibility, you have 12 months to disenroll from MA and purchase any Medigap plan with guaranteed issue. This is a critical second chance for those who chose MA initially and want to switch.

Are all Medigap policies guaranteed renewable?

Yes. Under Section 1882(c)(1)(D), once enrolled your coverage cannot be cancelled based on health status, age, or claims experience. Carriers can cancel only for non-payment of premium or material misrepresentation on the application.

What is a SELECT plan?

Under Section 1882(t), SELECT plans use a preferred provider network. You must use network providers for full benefits (with emergency exceptions). Premiums are typically 10-20 percent lower than standard plans. SELECT plans are less common in Georgia than in some other states.

Does Medigap cover Part D drugs?

No. Medigap does not cover prescription drugs. You need a separate Part D plan. Plans H, I, and J that included drug coverage were retired in 2006 when Part D became available.

Does Medigap cover vision, dental, or hearing aids?

No. Medigap covers only Medicare cost-sharing. Vision, dental, and hearing are not Medicare benefits. Some Medicare Advantage plans include these, but Medigap does not.

Does Medigap cover long-term care?

No. Medigap covers Medicare-covered services only. Custodial care, nursing home long-stays, and assisted living are not Medicare benefits and are not covered by Medigap.

What is the difference between attained-age and issue-age pricing?

Attained-age plans calculate premium based on your current age. Premiums increase as you age (in addition to general rate increases). Most Georgia plans are attained-age.

Issue-age plans calculate premium based on your age at enrollment. Premiums do not increase due to age (only general inflation and class rate adjustments). Initial premium is typically higher but more stable over time.

How do I shop for Medigap?

Three approaches: (1) Contact GeorgiaCares SHIP at 1-866-552-4464 for free unbiased counseling; (2) Use a licensed independent broker who represents multiple carriers; (3) Use the Medicare.gov Medigap policy search tool to compare plans in your area. Always compare at least 3-4 quotes.

What documentation do I need to enroll?

Standard documentation includes Medicare card, identification, proof of Part B enrollment, prior coverage documentation (if claiming creditable coverage to waive pre-existing condition waiting period), and application form. Outside OEP, expect health questions and possibly medical record release.

Can I cancel Medigap if I no longer need it?

Yes, you can cancel any time. However, if you later want to re-enroll outside OEP, you will face medical underwriting. Cancelling Medigap should be considered carefully, especially for older or sicker beneficiaries who would not qualify under underwriting.

What if a broker tries to sell me Medigap while I'm on Medicare Advantage?

Refuse and report the broker to Georgia Office of Insurance Commissioner (1-800-656-2298). Section 1882(d)(3)(A) makes this sale illegal with up to $25,000 federal civil penalties per violation.

How do I find a licensed Medigap broker in Georgia?

Verify licensure at Georgia Office of Insurance Commissioner (1-800-656-2298 or oci.georgia.gov). Reputable brokers will provide their license number and represent multiple carriers. GeorgiaCares SHIP can also refer you to trusted brokers in your county. :::

::: cta Georgia Medigap Resources

Federal Medicare

• Medicare 1-800-MEDICARE (1-800-633-4227)
• Medicare.gov Medigap policy search
• Social Security Administration 1-800-772-1213
• CMS Region IV Office (Atlanta)

Georgia State Resources

• DCH Medicaid Member Services 1-866-211-0950
• Georgia Office of Insurance Commissioner 1-800-656-2298
• GeorgiaCares SHIP 1-866-552-4464
• Palmetto GBA Georgia MAC 1-855-696-0705

Counseling and Advocacy

• AARP Georgia 1-866-295-7283
• Medicare Rights Center 1-800-333-4114
• Center for Medicare Advocacy 1-860-456-7790
• Justice in Aging 202-289-6976

Legal Help

• Atlanta Legal Aid Senior Citizens Law Project 404-377-0701
• Georgia Legal Services Program 1-800-498-9469
• 211 Georgia (general resources)
• Eldercare Locator 1-800-677-1116

Consumer Protection

• BBB Georgia Insurance Complaints
• Georgia Office of Insurance Commissioner Consumer Services :::

This article is part of Brevy's comprehensive Georgia Medicaid and Medicare resource library. For more on Medicare cost coordination, see our deep dives on QMB, SLMB, QI, the Medicare Buy-In, Medicare Secondary Payer rules, the Part B late enrollment penalty, and Medicare enrollment periods. Find personalized help navigating Medigap options in Georgia at brevy.com.

Disclaimer: This article provides educational information about Medicare Supplement Insurance (Medigap) and Georgia's coordinated Medicaid programs. It is not legal, financial, or medical advice. Federal and state rules change frequently, premiums vary by carrier and applicant, and individual circumstances vary. For specific guidance, contact GeorgiaCares SHIP, the Georgia Office of Insurance Commissioner, or a licensed insurance broker. Last verified: May 2026.