Alyssa Lane
Medicare Supplemental Insurance, also known as Medigap, helps cover the gaps in Original Medicare coverage, including out-of-pocket costs such as deductibles, copayments, and coinsurance. Individuals aged 65 or older who are enrolled in Medicare Parts A and B are eligible for Medicare Supplemental Insurance, with some states offering coverage to those under 65 with Medicare due to disability or end-stage renal disease. The annual Medicare Open Enrollment Period, from October 15 to December 7, allows individuals to change their Medicare coverage, including switching from Original Medicare to a Medicare Advantage Plan or vice versa. Outside of this period, individuals typically have a one-time, 6-month Medigap Open Enrollment Period to enroll in a Medigap policy starting from when they turn 65 and sign up for Medicare Part B. During this initial enrollment period, individuals can choose from any Medigap policy sold in their state without being subject to medical underwriting or higher premiums due to pre-existing conditions. However, switching Medigap policies outside of the initial enrollment period may be limited and result in higher costs.
| Characteristics | Values |
|---|---|
| Medicare Supplement Insurance plan, also known as | Medigap |
| Who is eligible for Medicare Supplement Insurance | People 65 and older enrolled in Medicare Parts A and B and in some states, people under 65 eligible for Medicare due to disability or End Stage Renal Disease |
| When can you enroll in Medicare Supplement Insurance | The first month you have Medicare Part B and you're 65 or older |
| How long is the enrollment period | 6 months |
| Can you enroll outside the enrollment period | Yes, in some situations, under "guaranteed issue rights" |
| What are "guaranteed issue rights" | Situations where an insurance company can't deny you a Medigap policy, e.g., if you lose other health coverage or move out of the plan's service area |
| Can you switch your Medigap policy | Yes, during the Medicare Open Enrollment Period each year or if you qualify for a Special Enrollment Period |
| Can you drop your Medigap policy | Yes, contact your insurance company to cancel it |
| Do you need to pay both premiums when switching policies | Yes, for the month that you have both policies |
| Do you need to inform your previous insurance company when switching policies | Yes, you need to cancel your old policy |
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What You'll Learn
Understanding Medicare Supplement Insurance
Medicare Supplement Insurance, also known as Medigap, is a type of health insurance policy sold by private insurance companies to complement Medicare policies. It covers common gaps in Medicare’s standard insurance plans, including out-of-pocket costs like copays, deductibles, and coinsurance.
Medigap is extra insurance that individuals can buy to help pay their share of out-of-pocket costs in Original Medicare. Generally, you must have Original Medicare – Part A (Hospital Insurance) and Part B (Medical Insurance) – to buy a Medigap policy. Some Medigap policies offer coverage when you travel outside the U.S., but generally, they do not cover long-term care, vision, dental, hearing aids, private-duty nursing, or prescription drugs.
The Medigap open enrollment period is six months from the first month of coverage under Medicare Part B for those 65 and older. During this period, you can switch to a different Medigap policy, and you have a 30-day "free look" period to decide if you want to keep your new policy. If you cancel your Medigap policy, you might not be able to get it or any policy back later.
In some cases, you may be able to buy a Medicare Supplement insurance policy outside of your Open Enrollment Period if you have a guaranteed issue right. For example, you may qualify if you lose other health coverage or if you have a Medicare Advantage plan and you've moved out of the plan's service area.
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Enrolling during the Open Enrollment Period
Medicare Supplement insurance, also known as Medigap, is available to those aged 65 and older enrolled in Medicare Parts A and B. In some states, those under 65 can also qualify for Medicare due to disability or end-stage renal disease. The Medicare Supplement Open Enrollment Period begins the first day of the month in which you are both aged 65 or older and enrolled in Medicare Part B. This is a one-time, 6-month enrollment period, and you can enroll in any Medigap policy during this time.
During the Open Enrollment Period, you will generally get better prices and more choices among policies. You can buy any Medigap policy sold in your state, and insurance companies cannot use medical underwriting to decide whether to accept your application. They cannot deny you coverage due to pre-existing health problems.
If you buy a Medigap policy during the Open Enrollment Period and decide you don’t like the policy, you can switch to a different Medigap policy. However, you will need to pay both premiums for the month that you have both policies. You have 30 days to decide if you want to keep your new Medigap policy (called a 30-day free look period).
If you don’t switch to another Medicare Advantage Plan during the yearly Medicare Open Enrollment Period, you will be automatically enrolled in Original Medicare. You can only join, switch, or drop a Medicare Advantage Plan (Part C) or Medicare drug plan (Part D) at certain times, called enrollment periods. The Medicare Open Enrollment Period typically runs from October 15 to December 7 each year, and your coverage will begin on January 1.
If you joined a Medicare Advantage Plan during your Initial Enrollment Period, you can change to another Medicare Advantage Plan or go back to Original Medicare within the first 3 months of having Medicare Part A and Part B.
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Switching or dropping your Medigap policy
Switching Medigap Policies
Medigap, also known as Medicare Supplement Insurance, helps cover the gaps in Original Medicare coverage, including out-of-pocket costs like deductibles, copayments, and coinsurance. You can generally only switch your Medigap policy during the Medigap Open Enrollment Period, which is a one-time, six-month period that begins when you are 65 or older and enrolled in Medicare Part B. During this period, you have the guaranteed acceptance to choose a plan that suits your needs without being subject to medical underwriting or higher premiums.
If you are within your Medigap Open Enrollment Period and want to switch to a different Medigap policy, you have the right to do so. You can explore different plans and choose one that better meets your needs. Remember that you may have to pay more for your new Medigap policy, and there might be a waiting period for coverage of pre-existing conditions.
In some specific situations, you may have the right to switch your Medigap policy outside of the Open Enrollment Period. These situations include guaranteed issue rights, such as losing other health coverage, moving out of your plan's service area, or experiencing issues with your current Medigap insurance company. Contact your State Insurance Department to understand your rights and opportunities for changing your Medigap policy.
Dropping Your Medigap Policy
If you decide to drop your Medigap policy, you must contact your insurance company to cancel it. Keep in mind that once you cancel your Medigap policy, you might not be able to get it or any policy back later. You will need to provide proof of your coverage termination and may have to apply within 63 days of your coverage ending.
Additionally, if you buy a new Medigap policy, you typically must cancel your old policy, except during the 30-day "free look period." During this period, you can temporarily have both policies and decide which one you prefer before cancelling the other.
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Guaranteed issue rights
The Medigap Open Enrollment Period is a one-time, six-month period that begins when an individual turns 65 and enrols in Medicare Part B. During this period, insurance companies must offer Medigap policies without considering health or charging higher premiums based on health. However, the Open Enrollment Period does not repeat, and missing this window may result in the loss of certain rights and opportunities.
It is important to note that guaranteed issue rights are not permanent and only last for a limited time. Therefore, individuals must be aware of the defined timeframes associated with each situation. To qualify for a plan change with a guaranteed issue right, individuals may need to provide documentation, such as a disenrollment letter from their insurance provider or other relevant correspondence.
Understanding guaranteed issue rights is crucial for individuals seeking to change their Medicare supplemental insurance during open enrollment. These rights provide protection and ensure access to Medigap policies, even outside of the standard enrolment period, by prohibiting insurance companies from denying coverage or charging higher premiums based on health-related factors.
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Cancelling your Medigap policy
Understanding the Process:
Firstly, you must contact the insurance company providing your Medigap policy and inform them of your intention to cancel. This communication should be made both in writing and verbally over the phone. When speaking to a representative, they can guide you through the specific steps required to complete the cancellation process. Some companies may require a formal termination letter, while others may ask you to fill out a disenrollment form. It is worth noting that your policy will typically remain in effect for the month you have already paid for.
Keeping Records:
Maintain copies of all relevant letters, notices, emails, or claim denials related to your coverage. These documents may be necessary when applying for a new Medigap policy, as they can prove your right to purchase a new plan.
Timing and Availability:
When you cancel your Medigap policy, it is unlikely that you will be able to get it back. Therefore, it is essential to carefully consider the timing of your cancellation. If you cancel your policy and later decide to re-enroll, you may face challenges in obtaining Medigap coverage again. Insurance companies are not standardised, and they may no longer offer the same policy. Additionally, insurers may reject your application or charge higher premiums due to pre-existing health conditions.
Switching Policies:
If you intend to switch to a different Medigap policy, it is crucial to understand your rights under federal and state laws. Contact your State Insurance Department to explore your options, as some states offer more opportunities for changing Medigap policies. Additionally, if you already have a Medicare SELECT policy for more than six months, you may be exempt from answering medical questions when switching policies.
Refunds and Unused Funds:
Some insurance companies offer refunds for unused funds when you cancel your Medigap policy. Be sure to discuss all the details involved in terminating your policy, including any potential refunds you may be entitled to.
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Frequently asked questions
The best time to buy a Medigap policy is during your Medigap Open Enrollment Period. This is a one-time, 6-month period that starts the first day of the month you're 65 or older and signed up for Part B.
The Medicare Supplement Open Enrollment Period is the 6-month period that starts the first day of the month in which you are both age 65 or older and enrolled in Medicare Part B.
In most cases, you won’t be able to switch your Medigap policy outside your 6-month Medigap Open Enrollment Period. However, there are specific situations when you have a guaranteed issue right, also known as Medigap protections, which allow you to switch outside of this period.
Guaranteed issue rights are situations in which an insurance company can’t deny you a Medigap policy outside of your Medigap Open Enrollment Period. For example, you may qualify if you lose other health coverage or you have a Medicare Advantage plan and you’ve moved out of the plan's service area.
To switch your Medigap policy, you must first buy a new Medigap policy and then cancel your old policy (except for during your 30-day "free look period"). Contact your insurance company to cancel your policy. You will need to keep any letters, notices, emails, or claim denials as proof of your coverage being terminated.
