- 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.
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, such as:
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.
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.
This period starts is the 6-month period that starts when you turn age 65 and have enrolled in Medicare Part B. If you enroll after this time, insurance companies may increase the monthly premiums due to medical underwriting. Medical underwriting is a process that’s used by insurance companies to make decisions about coverage based on your medical history. Medical underwriting is not allowed during Medigap initial enrollment.
You can still purchase a Medigap plan outside of your initial enrollment period. Here are the other time periods when you may enroll in a Medigap plan throughout the year:
- General enrollment (January 1–March 31). You may switch from one Medicare Advantage plan to another, or you can leave a Medicare Advantage plan, return to original Medicare, and apply for a Medigap plan.
- Open enrollment October 15–December 7). You may enroll in any Medicare plan, including a Medigap plan, during this period.
However, 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.
Tips for enrolling
Here are the basic steps to buying a Medigap policy:
- Evaluate what benefits are more important to you. Are you willing to pay some of a deductible, or do you need full deductible coverage? Do you anticipate needing medical care in a foreign country or not? (This is helpful if you travel a lot.) Look at our Medigap chart to determine what plans offer you the best benefits for your life, finances, and health.
- Search for companies that offer Medicare supplement plans by using the Medigap plan search tool from Medicare. This website gives information on policies and their coverage as well as insurance companies in your area that sell the policies.
- Call 800-MEDICARE (800-633-4227) if you don’t have internet access. The representatives who staff this center can help provide the information you need.
- Contact insurance companies who offer policies in your area. While it takes some time, don’t just call one company. The rates can vary by company, so it’s best to compare. Cost isn’t everything, though. Your state’s insurance department and services like weissratings.com can help you find out if a company has a lot of complaints against it.
- Know that an insurance company should never pressure you to buy a policy. They also shouldn’t claim to work for Medicare or claim that their policy is a part of Medicare. Medigap policies are private and not government insurance.
- Choose a plan. Once you have looked over all the information, you can decide on a policy and apply for it.
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.
What is “guaranteed issue right”?
If you have a guaranteed issue right, 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.
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