Medigap Enrollment Periods
The best time to enroll in a Medicare Supplement plan is during your 6-month time period called the Open Enrollment period. There is a possibility of enrolling in Medigap outside of the Open Enrollment Period but there’s no guarantee that you will get your Medigap policy if you don’t meet the medical underwriting requirements, unless you’re eligible due to certain reasons.
Medigap Open Enrollment Period
Your unique Medigap Open Enrollment Period allows you to choose any Medicare supplement plan without having to pass medical underwriting. This unique enrollment period happens just once in your life and is the best time to enroll in a Medicare supplement. You can enroll later, but you will be subject to medical underwriting and may be denied coverage based on your health history.
The Open Enrollment Period:
- Happens once per lifetime (unless the person is younger than 65 and is on disability)
- Begins on your Part B effective date and ends six months later
- Does not require you to answer questions about your health
- Is not the same as the Annual Enrollment Period
If you apply outside of your open enrollment period, you will have to pass medical underwriting to be allowed to join a plan. Even if you do pass, the insurance company can choose to charge you a higher monthly premium based on any pre-existing conditions.
This period often gets confused with the Annual Enrollment Period. The AEP is for Medicare Advantage (Part C) and Part D plans only and it occurs at the same time each year, October 15 – December 7.
For those turning 65, their Open Enrollment Period begins on their Part B effective date and ends six months later. This can also happen after 65 if you have chosen to delay enrollment into Part B because you had other creditable health coverage.
Planning for Your Open Enrollment Period
Those who begin the Medicare enrollment process early will get their Medicare ID card prior to their 65th birthday month. This is helpful when preparing for your Open Enrollment Period because as long as you have your Medicare ID, you can actually submit a Medicare supplement application prior to your Part B effective date. This will allow your coverage to begin as soon as possible.
This also benefits the individual because once your application is submitted, your rates are locked in. Rates are constantly changing (which usually means they’re increasing) so submitting an application as early as possible will help you get the best rate.
Second Open Enrollment Periods
We mentioned that your Medigap Open Enrollment Period happens just once in your life. While that is typically the case, there is one instance where an individual has two open enrollments where they are eligible to pick any Medigap plan without answering health questions.
Individuals who are on Medicare due to a disability and are younger than 65 usually have very limited options when choosing a Medicare supplement. Most of the time, the only plan available is Plan A, which only provides the most basic of health benefits. Because Plan A can be double or triple the premium for those under 65, many of these individuals choose to forgo coverage. When these individuals turn 65, they are granted a second Open Enrollment Period and can choose any of the available plans. Their rates will be the same as any other 65-year-olds as they will not be able to be increased due to their disability.
Take advantage of your
Medigap Open Enrollment Period
Medicare beneficiaries can have higher costs of healthcare. You want to make sure you find great coverage, but also at a rate that is competitive. Applying for a Medicare supplement during your open enrollment window is the best way to make sure you’re getting great rates. Plus, you want to make sure you’ve got the coverage you’ll need now and later in life, so enrolling in a plan during this time gives you the best options.
When to Enroll in a Medicare Supplement
You can enroll in a Medicare supplement at any point during the year if you are eligible for Medigap. Remember, unless you enroll during your Open Enrollment Period, you will have to answer questions about your health history and insurance carriers can deny coverage based on those answers.
The only way to forgo medical underwriting is if you qualify for a Special Enrollment Period.
There are states that have their own set of rules when it comes to open enrollment and guaranteed issue rights. For instance, California and Connecticut have unique rules. California has a birthday rule that allows you to enroll in a Medigap plan around the time of your birthday each year. You don’t have to pass medical underwriting, either. Connecticut has year-round open enrollment for all Medicare beneficiaries. Again, there is no need to go through medical underwriting.
Comparing the Open Enrollment Period
and the Annual Enrollment Period
These two enrollment windows in Medicare are often confused as many people use the terms interchangeably. They are most definitely not the same, but each of them is crucial to Medicare beneficiaries.
We’ve talked about what the Medigap Open Enrollment Period is, so let’s discuss the Annual Enrollment Period.
AEP happens each year beginning on October 15 and ending on December 7. During this time, Medicare beneficiaries can make changes to their Part C and Part D plans. They can enroll in one of these plans, disenroll from one, or change from one plan to another. Changes made during this time go into effect on January 1 of the upcoming year.
Both Part C and Part D plans change each year, so the AEP is an important window for anyone enrolled in one of those two types of plans.
AEP allows Medicare Advantage plan members to disenroll from their plan and switch back to Original Medicare and choose a Medicare supplement policy. However, the most common misconception is that they will be able to do this without passing medical underwriting. This is not the case. There are no guaranteed issue rights associated with the Annual Enrollment Period.
I missed my Medigap Open Enrollment Period!
If you missed your open enrollment for a Medicare supplement, you can still apply for a plan, but you may be denied coverage if you have certain pre-existing health conditions. If you are denied coverage, there are still options available to you.
Medicare Advantage plans do not require their members to undergo medical underwriting. (The only thing that can prevent you from getting coverage is if you have End-Stage Renal Disease.) While Medicare Advantage plans are not always a good option, they are definitely better than having no coverage at all.
If you choose to pursue a Medicare Advantage plan, you will have to wait until the Annual Enrollment Period to apply.