There is a lot of confusion about the open enrollment period for supplemental Medicare insurance (aka, Medigap). In this brief article, we’ll answer the two most common questions, including when is it and how long does it last.
When is Medicare Supplement Open Enrollment?
It’s easy to be tricked into thinking that open enrollment for Medicare supplement insurance is in the fall. That’s because Medicare itself puts out so much information about the Annual Election Period (AEP), which starts each October 15th and ends December 7th. Even the Medicare supplement insurance companies go crazy with Medigap ads during the fall. However, AEP is really only for Medicare Advantage plans and your Medicare prescription drug plan (Part D).
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Medigap plans do not have an annual open enrollment period and are not included in the fall AEP where you are free to switch plans no matter what. The reason for this is that supplemental insurance for Medicare does not have the same protections as Medicare Part C (Advantage Plans) and Medicare Part D (prescription plans).
Unlike traditional health insurance, which was overhauled by the Affordable Care Act (aka, Obamacare), Medicare supplement insurance is more like a hospital indemnity policy. These policies indemnify you from Medicare’s high out-of-pocket costs. And, because they are regulated like other types of indemnity insurance, the insurance companies can and will turn you down for pre-existing conditions. But, you do have a one-time open enrollment period when you are first eligible.
Medicare Supplement Enrollment Period Explained
When you first turn age 65 and qualify for your Medicare benefits, you have a six-month window to enroll in the Medigap plan of your choice without the fear of being turned down or charged more due to a pre-existing condition. You must be enrolled in both Medicare Part A and Part B, but you have a guaranteed issue right.
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Your guaranteed issue right, which starts on the effective date of your Part B coverage, means that insurance companies can’t ask you any questions about your health. They can ask you your age, gender, where you live, and your use of tobacco, but they can’t force you to ask the intrusive health questions. And, so long as you can afford to pay the monthly premium for the policy, they can’t turn you down.
Unless you live in one of the few states, like California, Oregon, and Washington State, that have enacted new guaranteed-issue legislation, your one-time open enrollment is the only time you are guaranteed to get the coverage you want. A few states have slightly different rules, which are covered below.
How Long is an Open Enrollment Period for Medicare Supplement Policies?
Your initial open enrollment period, to buy the Medigap plan of your choice guaranteed issue, is six months. Your guaranteed issue right starts the day your Medicare Part B coverage begins and ends six months later. In other words, if you don’t apply for a Medicare supplement plan within six months of first getting your Medicare Part B coverage, you will need to go through medicare underwriting to get a policy.
Medicare Supplement State Law Variations
A few states have implemented legislation that makes it easier to switch from one plan to another. Also, some states have made it easier for people under age 65 to get Medigap coverage.
In Connecticut and New York, Medicare supplements are guaranteed-issue all year long.
In Massachusetts, Medigap plans are guaranteed-issue February through March.
California and Oregon have birthday rules that give enrollees a 30-day window following their birthday each year when they can switch Medigap plans without going through medical underwriting, but only if they are going to a plan with the same or lesser benefits.
In Maine, Medicare beneficiaries can switch to a different Medicare supplement plan with the same or lesser benefits at any time during the year. Also, all Medicare supplement carriers must designate one month each year when Plan A, the plan with the fewest benefits, is available guaranteed-issue to everyone that qualifies.
Missouri has an anniversary rule that allows anyone with Medigap coverage a 60-day window around their plan anniversary each year during which they can switch to the same plan, guaranteed-issue, with another carrier.
Also See: Medicare Supplement Guaranteed Issue
If you are under 65 and eligible for Medicare due to a disability, Medicare supplement availability depends on the regulations in your state. There are no federal regulations or protections that guarantee Medigap enrollment for people under age 65.