Orlando Harmon
There are specific times when you can change your Medicare supplemental insurance, also known as Medigap. You can change your Medigap policy during the Medicare Open Enrollment Period, which occurs annually. You can also change your policy at other times if you qualify for a Special Enrollment Period. In most cases, you can only switch your Medigap policy during your one-time, six-month Medigap Open Enrollment Period. However, there are certain exceptions, such as when you have a guaranteed issue right. This right allows you to switch Medigap plans without insurers denying coverage for pre-existing conditions, and it typically lasts for 63 days. To determine when you can change your Medicare supplemental insurance, it is important to understand your federal and state rights and any specific situations that may apply.
| Characteristics | Values |
|---|---|
| When can you change Medicare Supplemental Insurance? | During your initial, one-time only, six-month Medigap Open Enrollment Period. |
| How often can you change? | You can't routinely switch during the annual open enrollment period. |
| When can you switch outside of the Open Enrollment Period? | In specific situations when you have a guaranteed issue right. |
| What is a guaranteed issue right? | When an insurance company can't deny you a Medigap policy. |
| When do you have guaranteed issue rights? | When you lose Medigap coverage through no fault of your own, such as the insurance company going bankrupt. |
| How long do you have to switch after losing coverage? | 63 days. |
| How long do you have to decide if you want to keep a new Medigap policy? | 30 days (30-day free look period). |
| What happens if you cancel your policy? | You can't get it back. |
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What You'll Learn
Switching during the initial open enrollment period
The first step in changing Medicare Supplement plans is determining eligibility. You can switch Medigap plans during your initial one-time only six-month Medigap open enrollment period. This period starts the first month you have Medicare Part B and you're 65 or older. If you are unhappy with your plan, you can choose a different one. You then have 30 days to decide whether to keep the new plan. This is called a 30-day free look period. During this time, you can switch to a different Medicare Supplement plan and get a full refund. However, you must pay the first month's premium for the old plan before switching to a new one.
If you switch without a guaranteed issue right, insurers are not required to cover your pre-existing conditions. They can also charge you more or deny you coverage altogether. You can qualify for a Special Medigap Enrollment period if you have a guaranteed issue right. During this 63-day period, insurers cannot deny you a Medigap plan, and they must cover your pre-existing health conditions. Insurance carriers also cannot increase the cost of Medigap insurance because of your current or past health history.
Some situations that permit you to buy a Medigap policy outside of your Medigap Open Enrollment Period include:
- You lose Medigap coverage through no fault of your own, such as the insurance company going bankrupt.
- You move out of the Medicare or Medigap plan network.
- Your Original Medicare plan or employer-sponsored health insurance plan pays after Medicare, and the plan is ending.
- Your Medicare Advantage Plan is leaving Medicare, or you're moving out of your Medicare Advantage Plan's coverage area.
- Your Medicare Advantage Plan didn't follow the rules or misled you.
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Cancelling your policy
You can cancel your Medigap policy at any time. However, if you cancel your Medigap policy, you might not be able to get it back or enrol in a new policy. This is because insurance companies are not required to sell Medigap to people under 65 who already have Medicare.
If you cancel your Medigap policy, you will have to pay more for your new policy and answer some medical questions. You might also not be able to get the same coverage in a newer Medigap policy.
To cancel your policy, contact your insurance company. You may need to provide your policy number, name, address, and the date you would like the cancellation to take effect. You will also need to provide a reason for the cancellation.
If you are cancelling your Medigap policy because you want to switch to a different one, there are certain situations in which you have a guaranteed issue right, meaning that insurance companies cannot deny you a Medigap policy. These include:
- You lose Medigap coverage through no fault of your own, such as the insurance company going bankrupt.
- You move out of the Medicare or Medigap plan network.
- Your Original Medicare plan or employer-sponsored health insurance plan pays after Medicare, and the plan is ending.
In these cases, you have 63 days to apply for a new Medigap policy.
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Guaranteed issue rights
Medigap policies are typically purchased during the one-time, six-month Medigap Open Enrollment Period. However, guaranteed issue rights allow individuals to obtain Medigap policies outside of this period under specific circumstances. These circumstances include situations where individuals lose their previous health insurance through no fault of their own, such as the insurance company going bankrupt or losing its certification to sell the plan. Additionally, guaranteed issue rights protect individuals from medical underwriting, ensuring that pre-existing health conditions or medical history do not impact their eligibility or premium rates for Medigap policies.
To exercise guaranteed issue rights, individuals should contact their State Insurance Department to understand their rights under state law. It is important to note that not all states offer the same opportunities to change Medigap policies, and federal law generally does not require insurance companies to sell Medigap policies to people under 65. However, some states may provide exceptions.
When switching to a different Medigap policy, individuals must pay premiums for both the old and new policies during the transition month. Additionally, they should be aware that they may have to pay more for their new Medigap policy and may need to answer medical questions.
In summary, guaranteed issue rights provide individuals with the opportunity to obtain Medigap policies outside of the standard Medigap Open Enrollment Period and protect them from medical underwriting, ensuring comprehensive coverage regardless of their health status.
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State laws
Guaranteed Issue Rights and Enrollment Periods:
Some states offer extended Medigap guaranteed issue rights, making it easier to purchase a plan outside of the standard 6-month Medigap Open Enrollment Period. This period typically begins when an individual turns 65 or enrolls in Medicare Part B. During this time, insurance companies cannot deny coverage due to pre-existing health conditions, and premiums are generally lower. However, switching plans outside of this enrollment period may result in higher premiums based on medical history.
State-Specific Plans and Regulations:
States like Massachusetts, Wisconsin, and Minnesota offer different standardized Medigap plans compared to other states. If you're moving to one of these states, you may need to switch plans and contact the state insurance department for specific information. It's important to note that insurance companies are not required to sell every plan available in a state.
Annual Switching Options:
Certain states allow Medigap plan members to switch plans annually, often around their birthday or the anniversary of their policy. This flexibility provides individuals with the opportunity to reevaluate their coverage needs and explore alternative options.
State Insurance Department as a Resource:
State Insurance Departments are crucial resources for understanding your rights and options under state law. They can provide information on guaranteed issue rights, eligibility requirements, and any additional opportunities or restrictions specific to your state. Contacting your State Insurance Department is especially important if you are considering changing your Medigap policy or if you have unique circumstances, such as being under 65 and eligible for Medicare due to a disability or ESRD.
Impact of Moving Out of State:
When moving out of state, it is generally not necessary to change your Medigap policy. Your current coverage will typically remain valid, but some rules and regulations may differ in your new state. Notify Medicare of your address change, as it can affect the cost of your Part B premium and your Medicare Advantage or Part D prescription drug coverage. Additionally, your new state may offer different Medigap plans, so exploring alternative options that better suit your needs may be beneficial.
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Switching insurance companies
One of the main opportunities to switch insurance companies is during the initial, one-time only, six-month Medigap Open Enrollment Period. This period begins in the first month that you have Medicare Part B and are 65 or older. During this time, you can switch to a different Medicare Supplement plan without any penalties. If you decide to switch during this period, you will have a 30-day free look period with the new plan, during which you can decide if you want to keep it or not.
Outside of the Medigap Open Enrollment Period, there are certain situations that grant you a "guaranteed issue right" or "Medigap protections", which allow you to switch insurance companies. These situations include instances where you lose your Medigap coverage through no fault of your own, such as the insurance company going bankrupt, or you moving out of the plan's network. You may also have a guaranteed issue right if your Original Medicare plan or employer-sponsored health insurance plan is ending. If you qualify for a Special Medigap Enrollment period due to a guaranteed issue right, you will have 63 days to apply for a new plan, during which insurers cannot deny you coverage based on pre-existing conditions or increase costs due to your health history.
It's important to note that if you cancel your Medigap policy, you may not be able to get it back, and you will likely have to pay more for your new Medigap policy. Additionally, in most cases, you will need to pay the premiums for both your old and new policies during the month that you have both.
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Frequently asked questions
The best time to buy a Medigap policy is during your Medigap Open Enrollment Period.
You can change your Medigap policy during the Medicare Open Enrollment Period each year or at other times if you qualify for a Special Enrollment Period.
Guaranteed issue rights are specific situations that allow you to switch or drop your Medigap policy. For example, if your insurance company goes bankrupt, you can switch to a different provider.
Yes, you will need to pay both premiums for the month that you have two policies.
Once you cancel your policy, you cannot get it back. If you drop your Medigap policy, you might not be able to get it or any policy back later.
