Key Takeaways
- Georgia requires a 6-month open enrollment period for Medicare Supplement starting at age 65
- During open enrollment, insurers cannot deny coverage or charge more for health conditions
- Georgia provides guaranteed issue rights in specific situations (losing coverage, etc.)
- Medicare Supplement plans must be standardized (Plans A through N)
- Georgia allows attained-age, issue-age, and community rating for Medigap premiums
Georgia Medicare Supplement (Medigap) Regulations
Georgia has adopted federal Medicare Supplement standards with state-specific implementation rules.
Open Enrollment Period
Georgia provides a 6-month open enrollment period for Medicare Supplement:
When It Begins
The 6-month period starts:
- First day of the month you are 65 or older AND
- Enrolled in Medicare Part B
Protections During Open Enrollment
- Guaranteed issue - Must be accepted regardless of health
- No pre-existing condition exclusions
- Standard rates - Cannot be charged more for health conditions
- Any plan available - Can choose any Medigap plan A through N
Exam Tip: The 6-month Medigap open enrollment period is a federal requirement that Georgia follows. During this period, insurers cannot use health underwriting.
Pre-Existing Condition Rules
During open enrollment:
- No waiting periods for pre-existing conditions
- Cannot be denied for health history
- Coverage effective immediately
Outside open enrollment:
- Insurers may apply up to 6-month pre-existing condition waiting period
- May deny coverage based on health
- Limited guaranteed issue situations
Guaranteed Issue Rights
Beyond open enrollment, Georgia provides guaranteed issue rights in specific situations:
Triggering Events
| Event | Guaranteed Issue Right |
|---|---|
| Losing employer coverage | Can purchase Medigap within 63 days |
| Leaving Medicare Advantage | Can return to Medigap (in most cases) |
| Medicare Advantage plan leaves area | Can purchase Medigap |
| Medigap insurer becomes insolvent | Can switch to comparable plan |
| Losing Medicaid eligibility | Can purchase Medigap |
Standardized Plans
Georgia requires Medigap plans to be standardized according to federal law:
Available Plans
| Plan | Benefits |
|---|---|
| Plan A | Basic benefits only |
| Plan B | Basic + Part A deductible |
| Plan C | Comprehensive (pre-2020 Medicare eligible only) |
| Plan D | Similar to C, no Part B excess |
| Plan F | Most comprehensive (pre-2020 Medicare eligible only) |
| Plan G | Like F without Part B deductible |
| Plan K | 50% cost sharing, out-of-pocket max |
| Plan L | 75% cost sharing, out-of-pocket max |
| Plan M | 50% Part A deductible |
| Plan N | Cost sharing, copays for visits |
Note: Plans C and F are only available to those who became eligible for Medicare before January 1, 2020.
Rating Methods
Georgia allows insurers to use different rating methods for Medigap premiums:
Rating Types
| Rating Method | Description |
|---|---|
| Attained Age | Premiums increase as you age |
| Issue Age | Premium based on age at purchase, doesn't increase due to age |
| Community Rate | Same premium regardless of age |
Key Points
- Insurers must file rates with the Commissioner
- Rate increases must be approved
- Different insurers may use different rating methods
- Shopping around can save money
Medicare SELECT
Georgia allows Medicare SELECT plans:
- Lower premium Medigap plans
- Must use network hospitals for non-emergency care
- Same standardized benefits as regular Medigap
- Network requirement for Part A benefits only
How long is the open enrollment period for Medicare Supplement in Georgia?
Which Medicare Supplement rating method results in premiums that increase as the policyholder ages?