Though Medicare plans cover a range of hospital services and medical costs, the gaps in coverage leave you with a cost-sharing responsibility, which can be challenging for adults on a fixed income. Medigap — supplemental insurance plans that cover most of what Medicare doesn’t — is a great way to lower out-of-pocket Medicare costs.
With 10 plans — A-D, F, G, and K-N — each plan of the same letter provides comparable benefits regardless of the provider. Medigap serves a wide range of cost-conscious Medicare enrollees. It’s why in 2022, 42% of Medicare enrollees had a Medigap policy.
While Medigap has a good reputation for saving on healthcare costs, many assume that it shares the same enrollment guidelines as other parts of Medicare. However, there are key differences, such as enrollment periods and guaranteed issue rights, that may influence your decision on which Medigap plan to choose. Here are some key details to know about how to change Medicare Supplement plans.
When can I enroll in or change my Medigap plan?
Like other parts of Medicare, you sign up for a Medigap plan during an Open Enrollment Period. However, unlike other parts of Medicare, open enrollment isn’t at a specific or standard time of year, and there is no Annual Enrollment Period.
Instead, your Medigap Open Enrollment Period is a one-time six-month period that starts the month you turn 65 and sign up for Part B (medical insurance). During open enrollment, insurance providers can’t refuse to sell a policy to an eligible enrollee, whether you have a pre-existing condition or not. They’re also not allowed to hike up premiums because of it.
This six-month period is one of the only times you can change your Medigap plan. Note that if you switch to a different Medigap policy during the six-month window, you may have a waiting period before the new policy covers your pre-existing condition. Once the six months are up, you may not be able to change Medigap plans unless you qualify under guaranteed issue rights.
Change Medicare Supplement plans with guaranteed issue rights
Guaranteed issue rights are conditions under which an insurance provider can’t deny you a new or different Medigap policy. For example, during your six-month open enrollment period, you have the right to select and be approved for a Medigap policy, regardless of any pre-existing conditions.
Likewise, when it comes to changing Medigap plans, you have a guaranteed issue right if your health ends, is no longer available, or your insurance provider goes bankrupt, or other qualifying life events. Here are some examples of guaranteed issue rights that would allow you to change your Medigap plan:
- If your Medicare Advantage (MA) plan is no longer available and you’re switching to an Original Medicare plan, you’re allowed to switch to most Medigap plans (except M and N) 60 days before or no more than 63 days after MA coverage ends.
- If you have a Medicare SELECT policy but move out of the policy’s service area, you have the right to buy any Medigap plan (except M and N) sold in your state 60 days before and no more than 63 days after Medicare SELECT coverage ends.
- If your Medigap insurance company goes bankrupt or if you’ve chosen to leave them because they haven’t followed the rules, you may purchase any Medigap plan (except M and N) no more than 63 days after your current Medigap coverage ends.
Some states have additional special circumstances under which you can qualify for guaranteed issue rights, so be sure to check state laws.
Does Medigap have a Special Enrollment Period?
Some Medicare parts have a Special Enrollment Period that allows people already enrolled in an Original Medicare or other insurance plan when there’s been a life event — a move, changes in job-based coverage, etc. However, Medigap doesn’t have a Special Enrollment Period.
Outside of the six-month Open Enrollment Period, you may change your Medigap plan if you have guaranteed issue rights, like if your plan changes substantially or you move away. There may also be special circumstances that allow you to switch Medigap plans based on state and federal law. Some states have “birthday rules” that will allow beneficiaries to make changes around their birthday each year.
Choose the right Medigap policy from the start
There’s no denying how effective Medigap plans are at covering out-of-pocket Medicare costs. To ensure you get the plan that meets your needs, use the one-time six-month Open Enrollment Period to sign up for Medigap and assess if your plan provides enough benefits and fits your budget. Outside of these six months, you may only be eligible to change your Medigap plan under certain circumstances or guaranteed issue rights.
If this feels overwhelming, it doesn’t have to. United Medicare Advisors can help you navigate Medigap enrollment periods and guaranteed issue rights so you get the coverage you need. Get in touch today.
Disclaimer:
The information provided in this blog post is intended for general informational purposes only and does not constitute medical advice. It is not a substitute for professional medical consultation or treatment. Always consult with a qualified healthcare provider for any questions you may have regarding a medical condition.
United Medicare Advisors does not endorse or recommend any specific products, treatments, or procedures mentioned in this article. Reliance on any information provided in this blog post is solely at your own risk. We encourage you to discuss any health concerns or questions with your doctor before making any decisions about your health, wellness, or treatment.
