Medicare Annual Enrollment & Medicare Supplement
It may get confusing to learn how Medicare's Annual Enrollment Period affects Medicare Supplement plans. Read on to learn about what this well-known period means for Medigap coverage.
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Whether you're interested in enrolling in a Medicare Supplement plan, or you're currently enrolled in a Medigap plan, Medicare's Annual Enrollment Period can be a confusing time to navigate.
It's important to note that you can enroll in or change a Medicare Supplement plan at any time. However, the Annual Enrollment Period (Oct. 15 - Dec. 7) provides an opportunity to evaluate your coverage and ensure any health, financial or lifestyle changes are addressed for the upcoming year.
Here's what to know about the Annual Enrollment Period and Medicare Supplement Insurance. Read on for more information, or jump to a section below.
Medicare Annual Enrollment Overview
Medicare's Annual Enrollment Period runs from Oct. 15 through Dec. 7 and is one of the most popular times of the year for electing new Medicare coverage. However, this period specifically applies to Medicare beneficiaries who are either currently enrolled in, or want to enroll in, Medicare Advantage (Medicare Part C) and/or Medicare Prescription Drug Plans (Medicare Part D).
It's important for anyone who is eligible for Medicare to understand this time period, but it does not necessarily affect all Medicare beneficiaries. You can still shop for other plan options including Medicare Supplement and dental, vision and hearing coverage - but these plans are not dependent on the Annual Enrollment Period to make changes.
Here is a general list of what you can do during the Annual Enrollment Period. Items highlighted in bold specifically apply to Medicare Supplement beneficiaries.
Switch from a Medicare Advantage plan to a Medicare Supplement plan
Enroll in or switch a Medicare Advantage plan
Switch from a Medicare Advantage plan to Original Medicare (Part A & B)
Replace Original Medicare (Part A & B) with a Medicare Advantage plan
Change your prescription drug plan (Part D)
Enroll in a Part D plan
Change from a Part D plan to a Medicare Advantage plan (if you are enrolled in Part A & B of Original Medicare)
Remove your Part D prescription drug coverage
Medicare Supplement Enrollment Periods
Once you have enrolled in Medicare Parts A & B, you can enroll in a Medicare Supplement plan at anytime. For most people, you become eligible to enroll in Original Medicare when you turn 65. And while you can enroll in a Medicare Supplement plan when at anytime, the best time to enroll is during your Medigap Open Enrollment Period.
Your Medigap Open Enrollment Period starts at the beginning of the first month that you are both 65 years old and are officially enrolled in Medicare Part B. It lasts for six months after this date. So, for example, if you turn 65 in August but don't start Medicare B until late September, your Medigap Open Enrollment Period will begin on October 1 and end April 1.
Enrolling during this period can help mitigate costs and ensure you get the best deal on your policy.
Month 1: Your Medigap Open Enrollment Period begins if you are 65+ and enrolled in Medicare Parts A & B.
Month 2: You're able to enroll in a Medigap plan.
Month 3: You're able to enroll in a Medigap plan.
Month 4: You're able to enroll in a Medigap plan.
Month 5: You're able to enroll in a Medigap plan.
Month 6: Your Medigap Open Enrollment Period ends at the end of the month; you can still enroll in a Medigap plan, but you may have to go through an underwriting process unless you have guaranteed issue rights.
The best time to enroll in a Medicare Supplement plan is during your Medigap Open Enrollment Period for several reasons:
- Guaranteed Issue: During this period, insurance companies must offer you a Medicare Supplement plan without considering your health status or imposing any pre-existing condition waiting periods. This means you cannot be denied coverage or charged higher premiums due to your health condition.
- More choices and affordable premiums: During the Medigap Open Enrollment Period, you have access to a wide range of Medicare Supplement plans from different insurance companies. This allows you to compare options and choose the plan that best suits your needs and budget. Additionally, since insurance companies cannot consider your health status, they cannot charge you higher premiums based on your medical history.
- No medical underwriting: Outside of the Medigap Open Enrollment Period, insurance companies may require medical underwriting, which involves reviewing your health history and potentially charging higher premiums or denying coverage based on pre-existing conditions. Enrolling during the Medigap Open Enrollment Period ensures you can secure coverage without undergoing medical underwriting.
- Continued coverage: If you delay enrolling in a Medicare Supplement plan beyond your Open Enrollment Period, there is no guarantee that you will be able to enroll in a plan later. Insurance companies may impose medical underwriting requirements, charge higher premiums, or even deny coverage altogether. Enrolling during the Medigap Open Enrollment Period ensures uninterrupted access to coverage.
It's important to note that while the Medigap Open Enrollment Period is an ideal time to enroll, you can still apply for a Medicare Supplement plan outside of this period. However, doing so may subject you to medical underwriting and potentially higher premiums.
Medigap & Annual Enrollment: What To Know
While Medicare's Annual Enrollment Period (AEP) is a highly publicized event each year, it is not specific to existing Medicare Supplement beneficiaries or those becoming Medicare eligible and wishing to enroll in a Medicare Supplement plan. However, this is a good time to evaluate your needs for the upcoming year and ensure your coverage meets your needs. This may include health changes, lifestyle changes or financial changes. For instance, if you're hoping to travel more outside of the United States, Medicare Supplement helps ensure you're covered in other countries.
If AEP does not coincide with your Medicare Supplement Open Enrollment period, you can still enroll in a Medigap plan. It may require medical underwriting.
However, in certain circumstances you may have guaranteed issue rights even after your Medicare Supplement Open Enrollment period. These circumstances include:
- Transition from an employer-sponsored group health plan: If you have both Medicare and an employer-sponsored group health plan, and the latter is ending, you have guaranteed issue rights to obtain a Medigap plan.
- Changes to a Medicare Advantage Plan: If you purchased a Medicare Advantage Plan that is leaving Medicare or no longer covers your area, you have the right to switch back to Original Medicare and Medigap within a year.
- Return from a Medigap policy to Medicare Advantage: If you switched from Original Medicare and Medigap to a Medicare Advantage Plan but less than a year has passed, you can exercise your guaranteed issue rights to switch back.
- Disruption in coverage from the Medicare Supplement Insurance company: If your Medicare Supplement Insurance company goes bankrupt or ceases your coverage without fault on your part, you have guaranteed issue rights.
Annual Enrollment & Guaranteed Issue: Know The Difference
If you're interested in Medicare Supplement plans, it's important to note that you cannot qualify for a guaranteed issue of a Medigap plan during AEP alone. You will need to go through other qualification standards to determine if you're eligible for a guaranteed issue of a Medicare Supplement plan - unless the Annual Enrollment Period coincides with your initial enrollment period.
