- Medicare supplement insurance is also called Medigap.
- You may enroll in a Medigap plan during your 6-month individual Medigap open enrollment window. This period begins the first day of the month you turn 65 years old.
- You may enroll outside of your Medigap open enrollment window — but if you do, you may pay more or be denied coverage, depending on your health and medical history.
Open enrollment for Medigap, also known as Medicare supplement insurance, is the 6-month period that begins the month you turn 65 years old and are enrolled in Medicare Part B.
You can’t change or repeat this period.
Medicare supplement insurance plans work with your original Medicare (parts A and B) coverage to help fill in any gaps in that coverage. These gaps may require you to pay out of pocket for certain costs.
Common gaps in coverage that you must pay out of pocket for can include:
When it comes to Medigap insurance, applying at the proper time is critical. It guarantees that you’ll have the best selection of plans and pay the lowest premiums.
Although you may be able to buy Medigap at a future time, the 6-month period after you turn 65 years old is considered the best time to enroll. This is because at this time:
- You can buy any Medigap policy sold in your state, regardless of your medical history or preexisting health conditions.
- You will generally get better prices.
- You can’t be denied coverage.
During your open enrollment period, by federal law, insurance companies can’t deny you coverage, and they must sell you a Medigap policy at the best available rate. This is true regardless of your current state of health or any preexisting conditions.
After this open enrollment period, however, insurance companies aren’t required to sell you a policy if you try to purchase one. And even if you are able to buy one, it may cost more, depending on your current or past health conditions.
If you apply for a Medigap policy outside of your open enrollment window, insurance companies offering Medigap are generally allowed to decide whether or not to accept your application.
They can also determine how much to charge you for the Medigap policy based on medical underwriting. This means that your medical history and current state of health may affect the amount you’ll pay.
Depending on where you live, you may be able to purchase an alternative type of Medigap policy: Medicare SELECT.
Medicare SELECT is basically the same as Medigap, but it restricts you to only doctors and hospitals that are part of a specific network.
If you purchase a Medicare SELECT policy, you have the right to switch to a standard Medigap policy within 12 months of your purchase.
If you don’t meet the medical underwriting requirements, you have no guarantee that an insurance company will sell you a Medigap policy after your open enrollment period.
The exception is if you have a guaranteed issue right. In this case, you can buy a Medigap policy outside of your open enrollment period.
You may have a guaranteed issue right if:
- You joined a Medicare Advantage (Part C) plan when you first became eligible for Medicare, but disenrolled from that plan within 12 months.
- You lost, through no fault of your own, a group health plan that had covered your Medicare cost sharing, paying secondary to Medicare.
- Your previous Medigap policy or Medicare Advantage plan ended its coverage or committed fraud.
- You moved out of the service area of your Medicare Advantage plan or Medicare SELECT policy.
If you have a guaranteed issue right, companies can’t deny you coverage and must sell you a Medigap policy at the best available rate, regardless of your health status.
In this situation, companies are also prevented from imposing a waiting period for coverage of any preexisting conditions.
The best time to purchase Medigap is during the 6-month open enrollment period that begins the month you turn 65-years old and are enrolled in Medicare Part B.
By taking advantage of your open enrollment period, you can buy any Medigap policy sold in your state. You can’t be denied coverage and you’ll pay the best available rate, regardless of any current or past health conditions.
If you purchase a Medicare supplement plan outside of your open enrollment period, you might:
- pay a higher premium
- have a waiting period for coverage
- be denied coverage