Summary:
Medicare Supplement insurance doesn’t have restrictions on enrollment periods the way other Medicare coverage does. As long as you’re enrolled in Original Medicare, Part A and Part B, you can apply for a Medicare Supplement insurance plan anytime.
The trick, though, is getting accepted into a plan if you have a pre-existing condition. In some cases, insurance companies that sell Medicare Supplement (Medigap) insurance are allowed to deny you coverage or charge you more if you have a health condition. The main exception is if you apply during your Medigap Open Enrollment Period. That’s when you have guaranteed-issue rights to buy a Medicare Supplement insurance plan, as explained below.
When can I buy a Medicare Supplement insurance plan with guaranteed-issue rights?
Generally, the best time to buy aMedicare Supplement insurance planis during your Medigap Open Enrollment Period (OEP). This period lasts six months and begins the first day of the month in which you are both 65 or older and enrolled in Medicare Part B.
For example, if your birthday is August 31, 1958, you’d turn 65 in 2023. Say you’re automatically enrolled in Medicare Part A & Part B. Typically, your Medicare coverage would begin August 1,2023. The first day of the month that you’re both age 65 or older, and enrolled in Medicare Part B, in this example is August 1, 2023. Your Medigap OEP would last until January 31, 2024.
The reason the OEP is important is that this is when you have guaranteed-issue rights to buy a Medicare Supplement (Medigap) insurance plan. Insurance companies can’t use medical underwriting during this time. Medical underwriting considers your health conditions and the costs to cover you.
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What are the rules to get into a Medicare Supplement insurance plan?
- First of all, you have to be enrolled in Original Medicare (Medicare Part A and Part B).
- Also, be aware that Medigap insurance plans don’t work with Medicare Advantage plans. If you have a Medicare Advantage plan and decide you’d rather have Medigap, you’ll need to drop your Medicare Advantage plan and return to Original Medicare first.
- When you don’t have guaranteed-issue rights to a Medigap plan, insurance companies may reject you or charge you more based on a health problem. But during yourOEP, you have guaranteed-issue rights. You could have any health problem and still be accepted into a Medicare Supplement insurance plan.
- If you apply for a Medicare Supplement insurance plan after your OEP is over, in most cases you don’t have guaranteed-issue rights. An insurance company may reject you or charge you more based on your health history. Read about other situations where you might have guaranteed-issue rights.
How do I enroll in a Medicare Supplement plan if I am under 65?
Federal law doesn’t require insurance companies to sell Medigap insurance plans to people under 65. If you are under 65 and have Medicare, you might want to find out if insurance companies in your state sell Medigap insurance plans to Medicare beneficiaries in your situation. Not every state requires insurance companies to sell Medigap plans to those under age 65.
If you are under 65, check with your state insurance department or your state’s SHIP programfor guidelines.
Are there other times I can enroll in a Medicare Supplement plan?
If you’re outside your Medigap Open Enrollment Period, you might still be able to buy a Medigap plan. If you have a health condition, your chances are better if you have guaranteed-issue rights. Here are some situations that could qualify you for guaranteed-issue rights, besides your OEP (not a complete list):
- You dropped your Medicare Supplement insurance plan to use your trial right to try a Medicare Advantage plan. Less than a year has passed and you want to switch back to Original Medicare.
- Your Medicare Advantage plan stops providing care in your area and you return to Original Medicare.
- You move out of your Medicare Advantage plan’s service area and you return to Original Medicare.
- Your Medicare Supplement insurance plan committed fraud or misled you
- Your Medicare Supplement insurance plan went bankrupt
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