by Russell Noga | Updated May 16th, 2023
Every day in the United States, approximately 10,000 Americans turn 65. When you reach this milestone in life, you automatically qualify for Medicare Parts A & B. You’re also eligible for enrollment into a Medicare Supplement plan to cover the healthcare costs not covered by Original Medicare Parts A & B.
When is open enrollment for Medicare supplement plans, and how long do you have to take advantage of this window?
This post unpacks everything you need to know about Enrolling in Medigap.
6-Month Medigap Open Enrollment Period
- The Open Enrollment period is a designated timeframe for people eligible for Medigap plans to register with an insurer for a policy.
- Enrolling in this period gives you automatic acceptance into your chosen plan without needing medical underwriting.
- The insurer cannot refuse your application if you use the open enrollment period to register your Medigap plan.
The 6-month Medigap open enrollment period for Medigap plans starts on the day your Medicare Part B coverage begins and lasts for the next six months.
During this time, no medical questions are asked and you are guaranteed the coverage.
Who Is Eligible to Enroll in Medigap Plans?
To be eligible for a Medigap policy, you must be a beneficiary of Original Medicare Parts A & B. Part A covers your hospital insurance and Part B is your medical insurance.
There are three ways to be eligible for Medicare Parts A & B.
- Turning 65 years old.
- You have a severe illness, such as amyotrophic lateral sclerosis (ALS) or end-stage renal disease (ESRD).
- You’re disabled and received Social Security Disability Insurance for the last 24 months minimum.
Can An Insurer Deny You a Medigap Plan?
An insurer can deny enrollment into a Medigap plan if you miss the 6-month Medigap open enrollment period and have a pre-existing medical condition. If you don’t take a plan in the open enrollment period, the insurer might require you to undergo medical underwriting to access the policy.
If the results of the underwriting process determine you are high risk to insure, the provider might decide to deny you access to its Medigap scheme. Medical underwriting regulations and laws vary by state, and we can advise you on the best approach to medical underwriting. Call us for more information.
What Are Medigap Guaranteed Issue Rights?
The “Guaranteed issue rights” refer to your right to buy Medigap policies in specific situations outside of the Open Enrollment Period. Some scenarios grant you these protections from medical underwriting processes involved with applying after the closure of the open enrollment window.
In these instances, the insurer must sell you a Medigap policy, and they must cover any pre-existing health conditions. The insurer cannot charge you a higher premium because you have a pre-existing health condition.
The following are examples of these scenarios.
- You join Medicare Advantage at 65 and want to change to Original Medicare within a year of taking a policy known as your “trial rights.”
- Your Medicare Advantage plan closes down, or you leave the service area.
- Your employer plan supplementing Original Medicare benefits ends.
- Your Medigap plan closes, or the insurer shuts down.
Coverage Complications for Pre-existing Conditions
If the above scenarios don’t apply, you fall outside guaranteed issue rights. As a result, you might be liable for the financial costs associated with treating your condition, and the insurer doesn’t have to cover these costs.
If you’re not in the guaranteed issue period, insurers can charge you a higher premium based on your health status, whether you smoke or have pre-existing health conditions.
Can I Enroll in Medigap Plans at Any Time?
The Medicare Annual Enrollment Period (AEP)runs from October 15 to December 7 every year. This period allows you to make changes to your coverage if you are already enrolled in Medicare. 57% of Medicare enrollees don’t use the period to check if they can make savings on their Medicare coverage.
Older enrollees are less likely to review their plans, with 66% of beneficiaries over 85 not leveraging the open enrollment period. Suppose you’re past your initial open enrollment period and want to join a Medigap plan. In that case, insurers can reject your application or charge you higher premiums depending on your age, where you live, and health status.
Sometimes, it might be illegal for a private insurer to offer you a Medigap plan. If you have a Medicare Advantage plan or are enrolled in Medicaid, the insurer may not offer you a Medigap policy.
Different insurers charge different premiums for the same Medigap policies. The biggest factor in determining rates, outside of personal data like your age and smoking status, is where you live.
A provider might charge you more for your plan if you live in one state than they would charge you in another. Medigap insurers also sell policies at different prices. So, one insurer might charge you a higher premium than another in the same state for the same plan and coverage.
Enrolled in Medicare Part A and B Only?
If you are enrolled in Medicare Part A and B, you may apply for a Medicare Supplement plan at any time during the year. You do not need to wait until a specific enrollment period.
The Difference Between Open and Annual Enrollment
The “Annual Enrollment” and “Open Enrollment” periods are two different things. The Medicare annual enrollment period (AEP) runs from October 15th – December 7th allowing you to make changes if you are already enrolled in Medicare. The changes you make to your plan come into effect on January 1 of the following year.
Your initial open enrollment period is when you first enroll in Medicare.
Frequently Asked Questions - Medicare Open Enrollment
What is the Open Enrollment Period for Medicare Supplement plans?
The Open Enrollment Period for Medicare Supplement plans, also known as Medigap, starts the month you turn 65 and are enrolled in Medicare Part B, lasting for six months. During this time, you can buy any Medigap policy sold in your state, regardless of your health status.
What happens if I miss the Open Enrollment Period for Medicare Supplement plans?
If you miss the Open Enrollment Period, you may still apply for a Medicare Supplement plan, but insurance companies can use medical underwriting. This may lead to a policy denial or higher premiums based on your health status.
Can I switch Medicare Supplement plans during the Open Enrollment Period for 2024?
You can switch Medicare Supplement Plans for 2024 at any time during the year if you are just changing plans. If you are disenrolling from a Medicare Advantage plan, then you will have to wait until October 15th to change to a Medigap plan.
What is the Open Enrollment Period for Medicare?
The Open Enrollment Period for Medicare, often referred to as the Annual Election Period occurs from October 15 to December 7 each year. During this time, you can make changes to your Medicare coverage.
Can I enroll in a Medicare Supplement plan outside the Open Enrollment Period?
Yes, you can apply for a Medicare Supplement plan at any time. However, outside of the Open Enrollment Period, insurance companies can use medical underwriting, which can affect your premiums and coverage acceptance.
Can I change my Medicare Advantage plan to a Medicare Supplement plan during the Open Enrollment Period?
Yes, during the Medicare Open Enrollment Period, you can switch from a Medicare Advantage plan to Original Medicare with a Medicare Supplement plan.
What changes can I make during the Medicare Open Enrollment Period?
During the Medicare Open Enrollment Period, you can switch between Medicare Advantage and Original Medicare, change Medicare Advantage plans, or add, drop, or change a Medicare Part D prescription drug plan.
When is the Open Enrollment Period for Medicare Part D?
The Open Enrollment Period for Medicare Part D, which provides prescription drug coverage, coincides with the general Medicare Open Enrollment Period, from October 15 to December 7 each year.
What is the Medicare Supplement Open Enrollment Period for those under 65?
Some states require insurance companies to offer at least one type of Medigap policy to people under 65. In these cases, the Open Enrollment Period for Medicare Supplement plans is six months starting from when you’re enrolled in Part B.
Are there Special Enrollment Periods for Medicare and Medicare Supplement plans?
Yes, Special Enrollment Periods can occur if you lose your current coverage, move, or experience other life changes. The rules vary depending on the situation and the type of Medicare or Medicare Supplement plan.
Russell Noga is the CEO of Medisupps.com, an online Medicare Agency and resource center helping Medicare beneficiaries learn about Medicare, Medigap and Part D drug plans, and Medicare Advantage plans since 2009. Russell is licensed in all 50 states and has been featured as a keynote speaker, and author of several publications, along with hosting the very popular Medisupps.com Youtube channel.