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Learn » Medicare Supplement » When Can You Join or Change Medicare Supplement Plans?

When Can You Join or Change Medicare Supplement Plans?

Medicare Supplement 101: applying sooner is generally better.

September 12, 2018 - By Hal Levy - read

MYTH: You have to wait until November to join a Medicare Supplement plan.
Fact: Most people can join or change Medicare Supplement plans any time.

Thankfully, you can compare and apply for Medicare Supplement plans whenever you want. If possible, you’ll want to apply during your unique Open Enrollment Period or Special Enrollment Period. During these times, approval is guaranteed at the lowest possible price.

New To Medicare? Open Enrollment

Already Have Medicare? Coverage Outside of Open Enrollment

Issues With Your Medicare Supplement? Special Enrollment

Still Curious? Enrollment Date FAQs

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Best Time To Get Medicare Supplement: Your Open Enrollment Period

Your 6-month Medicare Supplement Open Enrollment Period is the easiest time to join or change Medigap plans.

During your Open Enrollment Period, Medicare Supplement providers must:

  1. Offer you any plan they have (“guaranteed enrollment”)
  2. Offer you plans at the most favorable terms (“guaranteed lowest price”).

When Is Medicare Supplement Open Enrollment?
When to Apply for Medigap illustration | HealthCare.com

There’s no fixed time of the year for everyone to have a Medicare Supplement Open Enrollment Period.

The timing of your personal Medicare Supplement Open Enrollment Period (sometimes called an “Initial Enrollment Period”) depends on when you get Medicare Part A and B.

Specifically, your Medicare Supplement Open Enrollment Period begins on the first day of the month that you are:

  1. 65 years or older AND
  2. covered under Medicare Part B.

Your Medicare Supplement Open Enrollment Period then lasts for a total of six months.

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How Do You Find Your Medicare Supplement Open Enrollment Period?

If you wait until you turn 65 to enroll in Medicare Part B, then your Medicare Supplement Open Enrollment starts after you enroll in Part B. Your Open Enrollment Period must begin on the first day of the month.

  • Example A: You’re already 65, and you sign-up for Medicare Part B on June 14.
    • Your Medigap Open Enrollment Period doesn’t start until July 1st and it lasts until December 31.
  • Example B: You’re already 65, and you sign-up for Medicare Part B on June 1.
    • This means that your Medigap Open Enrollment Period is from June 1st to November 30.

If you get Medicare Part B before you turn 65, then your Open Enrollment Period starts the first day of the month you turn 65.

  • Example C: You enroll in Medicare Part B when you’re still 64. Your birthday is on August 8.
    • This means that your Open Enrollment Period starts August 1 (the first day of the month when you turn 65) and lasts until January 31.

Remember that your Medicare Supplement Open Enrollment Period lasts for six months, starting from the first day of the month in which you’re 65 and enrolled in Medicare Part B.

You Only Have One Medigap Open Enrollment Period: Once your Open Enrollment Period begins, it cannot be replaced or delayed. You should take full advantage of the this period’s benefits. Discover which plan suits your needs, then buy Medigap insurance within this six-month window.

You may be used to re-applying for health coverage every year if you bought private health insurance before enrolling in Original Medicare. However, your Medicare Supplement Open Enrollment Period only comes once.

Medicare Supplement Open Enrollment Deadline: Many people still join a Medicare Supplement after their Open Enrollment Period in which coverage is guaranteed.

If you miss your 6-month open enrollment deadline, many insurers will still offer you coverage. However, insurers will be free to deny you or charge you higher monthly payments. In all cases, Medicare Supplement plans are renewable for life once you’ve enrolled in the plan.

Applying early makes the difference between having affordable coverage for life, or having to jump through hoops for coverage in the future.

What If You’re Not Eligible for Open Enrollment? If haven’t met the Medicare Supplement open enrollment conditions for the first time, then you don’t have to worry about open enrollment just yet.

For example – if you’re 66 years old but have never enrolled in Medicare Part B because you are currently covered by an employer health plan – then your Open Enrollment Period has not yet occurred. Your Open Enrollment Period will only begin once you leave your group plan and enroll in Medicare Part B.

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When Is the Medicare Supplement Special Enrollment Period?

A Medicare Supplement Special Enrollment Period is like a second Open Enrollment Period, when you can join a Medicare Supplement without regard to your age or health conditions. It follows after certain circumstances, like:

  • Residency in California, Connecticut, Maine, Massachusetts, Missouri, New York, or Oregon during certain times of the year;
  • Issues with your existing Medigap plan, including service area changes or plan closure;
  • Misleading information sent from your plan provider; and
  • Deciding to cancel a Medicare Advantage or Medicare SELECT plan after less than one year.

If you act within two months of losing your Medicare Supplement coverage through no fault of your own, you probably have a guaranteed right to purchase new coverage without regard to your age or health conditions.

There’s no limit to the number of Medicare Supplement Special Enrollment Periods you can receive.

Same Protections As Open Enrollment: During a Special Enrollment Period, Medicare Supplement providers cannot deny you coverage or charge you anything but the lowest rate.

Shorter Than Open Enrollment: Special Enrollment Periods are generally shorter than your Open Enrollment Period. They usually last for two months.

What Are Guaranteed Issue Rights? When you have guaranteed issue rights (also called “Medigap protections”), then Medicare Supplement insurance providers are required to offer you a policy. They cannot deny coverage for pre-existing conditions or charge you higher rates.

Everyone is granted guaranteed issue rights during their Medigap Open Enrollment Period, and regains them during a Medigap Special Enrollment Period.

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Easily Get Coverage Outside of Open Enrollment

You can always apply for Medicare Supplement plans, whether or not you’re in a designated enrollment period.

In fact, experts say that many seniors are surprised at the wide variety of plans that those with pre-existing conditions can join well into their golden years.

Free To Apply At Any Time: Both traditional health insurance and Medicare Advantage plans restrict signups to a certain time of the year. Many people assume that this is the case for Medicare Supplement plans too, but it’s not so.

You can join a Medicare Supplement plan outside of an enrollment period. And you’re not required to join a Medicare Supplement plan at all.

It’s good to apply within your Open Enrollment Period because of the lowest-cost guarantee during that time. While enrollment isn’t guaranteed outside of your Open Enrollment Period, Medicare Supplement providers issue policies year-round.

Same Benefits No Matter When You Apply: Once you’re in, you’re in. The Medigap plan you get outside of your Medicare Supplement Open Enrollment Period will have the same coverage and guaranteed renewability for life.

Drawbacks To Applying After Open Enrollment: If you miss your Medicare Supplement Open Enrollment Period, you may be subject to medical underwriting. This means that your application could be denied by the insurance company offering the plan. Your application could also be accepted at a higher price than you were hoping to spend.

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FAQs About Medicare Supplement Enrollment

What Is Medicare Supplement?

Medicare Supplement plans (“Medigap”) are add-ons to Original Medicare (Medicare Part A and Part B). Unlike Medicare Advantage programs, these are not replacement plans for Original Medicare.

When you get sick or injured, deductibles and copays on Original Medicare are harsh. The solution is Medicare Supplement plans. They’re designed by the federal government, but sold by private companies.

Medicare Supplement plans are a valuable part of your complete Medicare coverage. These tightly-regulated plans pay the coverage gaps that Original Medicare would otherwise bill to you.

With so many Medicare Supplement providers to choose from, it’s no wonder folks are surprised when they can get Medigap at a competitive price at any age.

You can learn more about Medicare Supplement plans here.

Do You Need to Apply for Medicare Supplement Every Year?

Medicare Supplement is guaranteed renewable.

Your Medigap will automatically renew each year. Simply continue paying your monthly premiums so that your coverage will continue.

In the rare case that your insurer stops offering your plan, you will be informed well in advance. You’ll be able to join any Medicare Supplement plan at the lowest possible rate through a Special Enrollment Period. Even if you have a plan that’s no longer offered (like Plan J), you’ll be able to buy into that same plan if you can find a carrier who offers it.

When Can You Change Medicare Supplement Plans?

You can join or change Medicare Supplement plans whenever you like.

Unless you qualify for a Special Enrollment Period, though, you will need to be accepted by your replacement plan. Your replacement plan does not automatically have to accept you in most cases.

Applying for a credit card can lower your credit score, but there’s zero chance of a negative impact if you’re denied coverage by a new Medicare Supplement plan. You can continue to compare different companies until you find one that meets your needs.

Should You Wait to Apply for Medigap?

You should apply once your Medicare Supplement Open Enrollment Period begins. The actual application process is short and easy, but you don’t want to rush into a decision.

You may be healthy when considering whether to enroll, but it’s important to be ready for coverage in case your previous health issues flare up.

Pre-Existing Conditions May Not Be Covered If Your Insurance Lapsed: Even if you have pre-existing health conditions, you can generally join your choice of Medicare Supplement plan.

Still, enroll as soon as possible to avoid running into any issues tied to your health. While your Medicare Supplement plan can’t pick and choose which health issues to cover, your plan can delay coverage for conditions that were diagnosed or treated during the six months before you enroll, for up to six months after you enroll.

However, your plan cannot delay coverage for pre-existing conditions if you had continuous and comprehensive “creditable coverage” for the 6 months before you enrolled. And Medicare Part A and Part B will still cover you for those 6 months. Read more here.

What If You Have Employer Coverage? If you or your partner has group health coverage through a union or employer – and you want to keep that coverage for now – then you will not be penalized for waiting to get Medicare Supplement.

You may get a shorter Special Enrollment Period instead of an Open Enrollment Period once your group coverage ends. It’s best to check with your benefits manager for more info.

What If You Can’t Afford Medicare Supplement at This Time?

As we age, it’s increasingly likely that we will incur very high medical bills. Medigap plans ease this by covering up to 100 percent of common medical expenses – including coinsurance, deductibles, hospice care, and excess charges.

Joining a Medicare Supplement plan is a sound financial decision in its own right. In fact, half of Medicare Supplement enrollees make less than $30,000 per year.

All Medicare Supplement Plans except for Plan A are far less costly than they appear, as they cover the payment for your Medicare Part A deductible.

At first glance, you might think that Medicare Supplement paying only 20 percent of costs is a bum deal. Take a closer look, because Medicare Supplement comes into play when you’re faced with astronomical hospital bills.

Monthly Premiums Are Far Less Costly Than Paying Out-Of-Pocket for an Unexpected Medical Issue

Of course, no one likes paying monthly premiums, but Medigap benefits are extremely generous. To give a better idea of how much you could save on out-of-pocket costs by purchasing a Medigap plan, here are a few hypothetical situations:

Example A: You accidentally fracture your hip (90 percent of hip fractures happen to people over the age of 65).

The hospital you visit ensures that every one of your doctors and caregivers participates in Medicare. With Original Medicare, you’d be responsible for paying your deductible, plus 20 percent of the $65,000 average cost. Including an ambulance, surgery, physical therapy, and medical equipment, you would owe at least $13,000.

With Medigap Plan F, you’d simply pay an average of $2,400 per year in premiums, no matter how high the cost of treatment becomes.

Example B: You have unusual chest pain and make the smart choice to rush to the emergency room. You’re admitted to your local nonprofit hospital and observed for two days.

It turns out to be nothing, but the bills for your inpatient care are off-putting: $4,578 on average. With just Original Medicare, you would have been on the hook for $1,062 ($879 for 20 percent of the cost, plus a $183 deductible for each stay). Under some Medigap plans, your hospital stay would cost you nothing.

How Long Does the Medigap Application Process Take?

You will need basic personal information about yourself and your existing Medicare coverage to apply for a Medicare Supplement policy.

Medicare Supplements can only be sold by licensed insurance agents. These agents are trained to present you multiple options from different companies. Agents make the process as easy and pressure-free as possible, on the phone or online.

Once you select a specific Medicare Supplement plan, the application process should take less than an hour. It would be a mistake, though, to wait until the last minute to select a plan.

Can You Apply for Medigap If You’re 64 Years Old Or Younger?

Not all states require Medicare Supplement plans to cover people with Medicare under 65 years old. 32 states require insurance companies to offer plans to people under age 65 who otherwise qualify for Medicare.

31+ states that mandate Medigap for people under 65

(Source: Centers for Medicare and Medicaid Services)

If you live in a state that doesn’t require Medicare Supplement availability for younger people, insurers may still offer you a Medicare Supplement plan, usually at a higher price.

Can You Get Medicare Supplement If You Have Medicare Advantage?

Medicare Advantage is a private program that combines Medicare Part A & Medicare Part B coverage with some Medigap-like benefits. You cannot have both Medigap and Medicare Advantage coverage at once.

You can switch from Medicare Advantage to Original Medicare and back during the Annual Election Period, which lasts from October 15 through December 7.

Yearlong “Free Look” Period for Medicare Advantage: If you have tried Medicare Advantage for less than a year and would prefer to revert to Original Medicare with a Medicare Supplement, then you have have guaranteed issue rights. This gives you a Special Enrollment Period in which you can purchase any Medicare Supplement plan under the most favorable terms.

 

Can Spouses Get Coverage Under A Medicare Supplement Policy?

Unlike health insurance for people under the age of 65, Medicare Supplement plans will not cover your spouse or other individuals in your household. They will need to apply on their own for Medigap coverage.

Who Offers Medicare Supplement Plans?

Medicare Supplement plans are designed by the government and sold by private insurance companies. The only difference between plans of the same letter type (like all Plan Ns) is price. Blue Cross Blue Shield and AARP are some of the popular Medicare Supplement providers which you can price compare on HealthCare.com.

Are There Medigap Plan Options In Your Area?

Medicare Supplement availability and rates depend on your state and ZIP code. Medigap plans are standardized lettered Medigap plans, meaning that a Medigap Plan F in Utah offers the same benefits as a Medigap Plan F in Massachusetts.

The only difference between plans of the same letter is price, no matter which company offers them.

How Do You Know If You’re Covered By Medicare Supplement?

Once you enroll in a Medigap plan, your insurer will send you materials in the mail. If you have an email account, you may receive immediate confirmation of your coverage.

It’s easy to confuse a Medicare Supplement Plan B with Medicare Part B. To determine whether or not you have a Medicare Supplement plan, check out the name of the plan. If it is “Plan A”, “Plan G”, or another combination of “Plan” and a letter, then it’s a Medicare Supplement.

How Do You Decide Which Medigap Plan Is The Best One?

There are 10 types of Medigap plans, each with benefits defined by the federal government.

Medicare is accepted by most medical professionals, and Medicare Supplement is accepted by anyone who takes Medicare.

Each plan will have pricing and plan documentation available on the web that you can compare. Consider your health needs when deciding which Medicare Supplement plan is right for you.

Medigap Plan Types | HealthCare.com

You can call a locally-licensed, independent broker via HealthCare.com to get free, no-obligation help with comparing local plans.

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