What is the Medigap Open Enrollment Period?
Key Takeaways
- The Medigap Open EnrollmentIn health insurance, open enrollment is a period during which a person may enroll in or change their selection of health plan benefits. Health plan enrollment is ordinarily subject to restrictions. Period starts once a person’s Medicare Part B coverage starts and lasts only six months.
- During the Medigap Open Enrollment Period, Part B beneficiaries can enroll in Medicare supplement insuranceMedicare Supplements are additional insurance policies that Medicare beneficiaries can purchase to cover the gaps in their Original Medicare (Medicare Part A and Medicare Part B) health insurance coverage. with guaranteed-issue rightsGuaranteed-issue is a right granted to Medicare beneficiaries and applies to Medicare Supplement insurance (aka, Medigap plans). All states and the federal government enforce this essential right, which protects Medicare beneficiaries from medical underwriting..
- Guaranteed-issue rights protect a person from being denied supplemental insurance due to their pre-existing conditionsA pre-existing condition is any health problem that occurred before enrolling in a health plan. The Affordable Care Act law made it illegal for health plans to or charge more due to a pre-existing condition.....
- Certain states may have special enrollment periodsEnrollment periods are designated time periods to enroll or disenroll from the various parts of Medicare. There are six Medicare enrollment periods. for Medigap outside of its Open Enrollment Period.
- Medigap is not compatible with Medicare Part CMedicare Part C is Medicare's private health plan option. Also known as Medicare Advantage, Medicare Part C plans are a type of Medicare health plan offered by companies that contract with Medicare to provide all... (Medicare Advantage)
When is the Medigap Open Enrollment Period?
The Medigap Open Enrollment Period (Medigap OEP) is a six-month period to enroll in Medicare supplement insurance (Medigap) that starts once a beneficiary’s Medicare Part B coverage begins. Medigap policies start the 1st of the month after a beneficiaryA person who has health care insurance through the Medicare or Medicaid programs. enrolls.
Beneficiaries can enroll in Medigap policies outside of the Medigap OEP, but only have the benefit of guaranteed-issue rights when enrolling during this one-time period.1Medicare.gov, “When can I buy Medigap“, Accessed September 25, 2021
What are Guaranteed-Issue Rights?
Guaranteed-issue rights protect beneficiaries from being denied a policy or charged extra costs because of their pre-existing health conditions. This means that during the Medigap OEP, any Medicare supplement insurance policy would be available to beneficiaries regardless of their health history. Otherwise, they would have to go through medical underwriting and that might mean they would lack eligibility for certain Medigap policies.2Medicare.gov, “Guaranteed issue rights“, Accessed September 25, 2021
Depending on the state a beneficiary lives in, they may be allowed to enroll in Medigap with guaranteed issue rights during special annual periods. For example, California and Oregon allow for a 30-day period after a person’s birthday to switch Medigap supplement policies that have equal or less coverage3Insurance.CA.gov, “Medicare Supplement Insurance ‘Medigap’“, Accessed September 25, 20214Shiba.Oregon.gov, “When can you switch Medigap plans“, Accessed September 25, 2021.
Medigap and Medicare Advantage
Medigap policies do not work with Medigap Advantage plans. It is illegal for insurance companies to sell Medigap policies while a beneficiary has Medicare Advantage5Medicare.gov, “Medigap & Medicare Advantage Plans“, Accessed September 25, 2021.
Beneficiaries have a “trial right” to buy a Medigap policy if they plan to switch from a Medicare Advantage planMedicare Advantage (MA), also known as Medicare Part C, are health plans from private insurance companies that are available to people eligible for Original Medicare (Medicare Part A and Medicare Part B). to Medicare Part A and Part B within 12 months2Medicare.gov, “Guaranteed issue rights“, Accessed September 25, 2021. “Trial rights” also allow beneficiaries to get back a Medigap policy if they had it before joining and dropping a Medicare Advantage plan5Medicare.gov, “Medigap & Medicare Advantage Plans“, Accessed September 25, 2021.
Citations
- 1Medicare.gov, “When can I buy Medigap“, Accessed September 25, 2021
- 2Medicare.gov, “Guaranteed issue rights“, Accessed September 25, 2021
- 3Insurance.CA.gov, “Medicare Supplement Insurance ‘Medigap’“, Accessed September 25, 2021
- 4Shiba.Oregon.gov, “When can you switch Medigap plans“, Accessed September 25, 2021
- 5Medicare.gov, “Medigap & Medicare Advantage Plans“, Accessed September 25, 2021