Medicare provides adults over 65 and people with certain disabilities with affordable hospital and medical health insurance. While Medicare covers a fair amount, it doesn’t cover everything. Medicare Supplement Insurance — also known as Medigap — covers the extra out-of-pocket costs so you can get the healthcare you need.
For adults considering early retirement or moving off employer-sponsored plans, there can be some confusion around the requirements and enrollment periods for Medigap. Here’s what you need to know to ensure you sign up for Medicare Supplement.
Medigap open enrollment vs. Medicare initial enrollment vs. Medicare open enrollment
First, it’s important to know that Original Medicare, Medicare Advantage, and Medicare Supplement all have different enrollment periods.
Medicare enrollment begins three months before you turn 65 and ends three months after your 65th birthday. If your birthday falls on January 1, open enrollment starts four months before your birthday and lasts for two months after. This is known as your Initial Enrollment Period (IEP). During your IEP you can enroll in Part A and/or Part B (Original Medicare), and Medicare Part D.
Each year, there’s the Annual Enrollment Period from October 15 to December 7, during which time you can enroll in Medicare Advantage or make changes to your Medicare Part D plan if necessary. Your plan will stay the same for the next year if you don’t make any changes during annual open enrollment, but you won’t be able to make any adjustments until the next Annual Enrollment Period.
These two enrollment periods are different from the Medigap Open Enrollment Period, which is a one-time event like your Initial Enrollment Period.
When is the Medicare Supplement Open Enrollment Period?
The one-time Medigap Open Enrollment Period starts once you have turned 65, and you have enrolled in Medicare Part B (medical insurance). Some states have additional Open Enrollment Periods, including for people under 65 — plan options during those additional enrollment periods might be restricted.
Medigap open enrollment lasts for six months after you’ve enrolled in Part B. During this time, you can enroll in any Medigap policy. If you wait until after your Medigap Open Enrollment Period, you may need to go through medical underwriting and could pay a higher premium than when you were first eligible
What to know about pre-existing conditions for Medigap enrollment
It’s also important to note that insurance companies can’t charge you more for a Medigap policy or deny you coverage if you have a pre-existing condition. If you have a pre-existing condition, there might be a “pre-existing condition waiting period,” during which time your insurance company can opt out of paying your out-of-pocket costs for up to six months. This caveat applies if your condition was treated or diagnosed within the six months prior to your enrollment in coverage.
However, they can’t make you wait to get coverage for your pre-existing condition if:
- You’ve had six months of continuous health coverage from another plan or policy (known as creditable coverage) with a break in coverage lasting no more than 63 days.
- You have guaranteed issue rights, also known as Medigap protection (e.g., if your health coverage changes in some way or you lose other coverage).
What are my options if I miss the Medigap Open Enrollment Period?
You don’t always have to sign up for Medicare Supplement insurance when you turn 65. For example, if you’re still on employer-issued insurance, you can delay Medicare Part B enrollment until that coverage ends.
Still, sometimes life happens, and you miss the enrollment period or don’t enroll in a Medigap plan because you think Original Medicare is enough to care for your health needs. Fortunately, even if you miss the enrollment period, you can still enroll in a Medigap policy with underwriting.
Be prepared for your Medicare supplement enrollment period
Keeping track of the different enrollment periods can be confusing. But we can help — contact United Medicare Advisors today.
