Enrolling in Medicare Supplemental Insurance

Medicare supplemental insurance, also known as Medigap, can help pay for costs that original Medicare does not cover. Here’s what you need to know about the best time to purchase a Medigap policy.

Understanding Medicare Supplemental Insurance

Medicare supplemental insurance is sold by private insurance companies to help fill gaps in original Medicare coverage. These Medigap plans cover some or all of the out-of-pocket costs of Medicare Part A and Part B, such as:

• Deductibles
• Copayments
• Coinsurance

There are 10 standardized Medigap plans, labeled Plan A through Plan N. Each offers a different combination of basic and extra benefits. Every Medigap plan offers the same basic benefits, no matter which insurance company sells it.

Determining the Best Enrollment Period

You have a one-time six month Medigap Open Enrollment Period when you:

• Are at least 65 years old, AND
• Are enrolled in Medicare Part B

During this time frame, you have a guaranteed right to buy any Medigap policy sold in your state. You cannot be turned down or charged more due to any existing health problems.

When does this six month period start?

It begins the first day of the month you are:

• 65 or older, AND
• Enrolled in Medicare Part B

If you are under 65 and receive Medicare due to a disability, your Open Enrollment Period starts when you enroll in Medicare Part B.

Why Enroll During the Open Enrollment Period?

Enrolling in a Medigap plan during your Medigap Open Enrollment Period gives you these key protections:

Guaranteed issue rights

Insurers must sell you any Medigap policy they offer. They cannot deny you coverage or charge you more due to any pre-existing conditions.

No underwriting

Insurers cannot ask health questions or require medical exams to determine eligibility or premium costs. You must be charged the same premium as those in good health buying that Medigap plan.

Lock in lower premiums

Insurers generally charge higher premiums if you enroll after your Medigap Open Enrollment Period. Even if you are in good health, you are likely to pay from 30% to 50% more on average compared to enrolling when first eligible.

Choosing from the Available Plans

During your Medigap Open Enrollment Period, you can buy any policy the insurer offers. Carefully consider what plan gives you the coverage that meets your needs and fits your budget.

The most popular options are Plan F and Plan G. About 57% of enrollees choose one of these two plans since they offer coverage for nearly all gaps in Medicare-covered services.

Enrolling On Time

Mark your 65th birthday or Medicare Part B effective date on your calendar. Contact insurance agents and Medicare supplemental insurance companies during the three months before your Medigap Open Enrollment Period starts.

This gives you time to compare Medigap policies thoroughly. You’ll know the pricing and coverage details to make an informed plan selection immediately when your six month window opens.

Frequently Asked Questions

What if I’m eligible for Medigap but decide not to enroll right away?

You can still purchase a policy later. However, the insurance company can ask medical questions, require an exam, exclude pre-existing conditions temporarily, and charge you more due to health status or age.

When does my Medigap Open Enrollment period end?

It lasts for six months from the first date that you are 65 or older and enrolled in Medicare Part B.

Can I change Medigap plans after my enrollment period?

Yes, you can change plans at any time. But unless certain limited conditions apply, your new plan can exclude pre-existing conditions for up to six months and charge you more due to age or health.

Do all Medigap open enrollment periods last six months?

In most states, the Medigap open enrollment period is six months long. But some states do extend this guaranteed access period to as long as 12 months.

If I drop my Medigap policy, can I get it back?

In most cases, yes – you have a legal right to buy back coverage if you drop a Medigap policy. However, the insurance company can ask medical questions, exclude pre-existing conditions, and charge you more for your age and health status when you reapply.

Understanding when you qualify for your one-time Medigap Open Enrollment Period is key. This six month window gives you an invaluable opportunity to buy the plan you want at the lowest available price. So be sure to enroll in a Medicare supplemental insurance policy as soon as you are eligible. Comparing plans ahead of time ensures you’ll choose the right coverage at the best rate.