Can You Enroll In Medicare Supplement Plans At Any Time?
Yes, as long as you have Medicare, you can enroll in a Medicare Supplement plan, also known as a Medigap plan, whenever you want. That said, there are specific enrollment periods for Medigap that can help you save money and get better coverage. If you are enrolled in Medicare Part B, you can enroll in any Medigap policy within six months of your 65th birthday without medical underwriting.
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Medigap a Popular Option to Bolster Medicare Coverage
Medigap is popular because Original Medicare has gaps in coverage. It does not pay for 100% of your care, meaning you might pay a lot out of pocket to see the doctor or have a procedure. About 14.6 million Medicare beneficiaries also have a Medigap plan to help round out their benefits.
When you choose a Medigap plan, you get help closing those coverage gaps and lowering your medical bills. While private insurance companies sell Medicare Supplement plans, Medicare dictates exactly what each one covers. Currently, there are ten plans that offer a variety of benefits. For example, some cover your Part B deductibles, Part A coinsurance, or skilled nursing facility care costs, which Original Medicare does not cover.
These 10 Medigap plans are:
- Plan A: Basic benefits including Medicare Part A and B coinsurance/copayment and hospice care coinsurance/copayment.
- Plan B: All benefits of Plan A plus coverage for Medicare Part A deductible and skilled nursing facility care coinsurance.
- Plan C: All benefits of Plan B plus coverage for Part B excess charges and foreign travel emergency.
- Plan D: All benefits of Plan B plus coverage for skilled nursing facility care coinsurance, Part A deductible, and foreign travel emergency.
- Plan F: All benefits of Plan C plus coverage for Part B deductible and excess charges, and foreign travel emergency.
- Plan G: All benefits of Plan F except for Part B deductible, plus coverage for skilled nursing facility care coinsurance and foreign travel emergency.
- Plan K: Covers 50% of Medicare Part A and B coinsurance/copayment, blood, hospice care, and skilled nursing facility care coinsurance.
- Plan L: All benefits of Plan K plus coverage for 75% of Part A and B deductibles.
- Plan M: All benefits of Plan D plus coverage for skilled nursing facility care coinsurance, Part A deductible, and foreign travel emergency.
- Plan N: All benefits of Plan D except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in an inpatient admission, plus foreign travel emergency coverage.
Enrolling in these plans is not free; they require a monthly premium. Further, private insurance companies have control over what they charge for these premiums. However, if you visit the doctor often and have many medical bills, paying a little extra a month for Medigap is likely cheaper than paying out of pocket for everything Medicare does not cover.
Enrollment Periods for Medicare Supplement Plans
If you’re still wondering — can I buy a Medicare Supplement plan at any time? — the answer is yes. However, doing so during a Medigap-specific period can be helpful for several reasons. Consider the following enrollment periods if you’re looking into a Medigap plan.
Initial Initial Enrollment Period
- Duration: Six months
- When It Begins: Starts the first day of the month you’re at least 65 and are enrolled in Medicare Part B.
- What You Can Do: Enroll in Medigap for the first time without medical underwriting and with all available plan options
During your initial enrollment period, you have guaranteed issue protections. This means insurance companies cannot refuse to sell you a Medigap plan for any reason. For example, they cannot deny you based on your medical history or charge you more because of it. During this time, you can benefit from more plan choices with lower costs.
Annual Enrollment Periods, or Birthday Rule Periods
Some states have special annual enrollment periods where you have a select amount of time to enroll in a new Medigap policy. These periods usually fall between 30-60 days after your birthday. However, many of these birthday rule periods apply to switching Medigap plans, not signing up for a new one. These states are:
Still, there is one big benefit to signing up for a plan at this time. Many states do not permit insurance companies to raise your rates based on age or health status during this enrollment period.
Open Enrollment Period for Medigap
- When: Varies
- Where: Connecticut, Massachusetts, Maine, and New York
- What You Can Do: Enroll in Medigap for the first time or change plans without medical underwriting and with all available plan options
Four states, Connecticut, Massachusetts, Maine, and New York, have their own open enrollment periods each year for Medigap. In Connecticut and New York, open enrollment is year-round, meaning you can get a plan at all times without being charged extra for your age or health status.
Special Enrollment Period (SEP)
There are a few special instances where you can buy a Medigap policy with guaranteed issue rights outside of open enrollment. For example, suppose you got a Medicare Advantage plan when you turned 65 but want to switch back to Original Medicare a few years later. In that case, you have 60 days before and 63 days after your Medicare Advantage plan ends to enroll in Medigap.
Another example of a special enrollment period is if you’re under 65 and have a disability or end-stage renal disease. Some states let you buy a plan early. Contact your state’s Medicare office to see what special enrollment periods you might qualify for.
Common Qualifying Events for a Medigap SEP
- You move to a new area. Since insurance providers base premiums on healthcare costs where you live, moving to a new area means you have a right to pick out a new plan.
- Your plan ends its contract with Medicare. This gives you the right to find a plan from a different provider without penalty.
- You lose your employer-sponsored health insurance. You may be eligible to enroll in Medigap if you’re making the switch to a Medicare plan.
Other Medicare Enrollment Periods That May Impact Medigap
The enrollment periods for Original Medicare are not the same as the enrollment periods for Medigap. However, if you do make changes to your Medicare plan during an enrollment period, it can affect your Medigap eligibility.
Medicare Open Enrollment Period
The Medicare open enrollment lasts from October 15 to December 7. If you want to switch from Original Medicare to a Medicare Advantage plan, you usually have to wait until this period to enroll in Medicare. You can also switch or drop your Medicare drug coverage. Coverage for any changes starts on January 1.
Switching to a Medicare Advantage plan during this period means you lose your eligibility for your current Medigap plan. That’s because you’re not allowed to have both Medicare Advantage and a Medigap policy. Frequently Medicare Advantage plans cover services that Original Medicare does not, with this coverage paid for with a single premium.
Medicare General Enrollment Period
Medicare’s general enrollment period is January 1 to March 31 every year. During this time, you can switch to a Medicare Advantage plan or drop your Medicare Advantage plan and go back to Original Medicare. Your coverage kicks in the month after you sign up.
Switching to Original Medicare means you have less coverage than with your Medicare Advantage plan, so you may want a Medigap policy to help reduce your costs. Also, if you sign up for Medicare Part B for the first time during this period, it can kick off your initial enrollment period for Medigap. Therefore, the clock is ticking for you to choose a Medigap plan with guaranteed issue rights.
Enrolling in Medigap Outside of Designated Enrollment Periods
It is possible to enroll in Medigap year-round. However, you may face penalties for doing so. Here’s a look at the potential downsides of signing up for a Medicare Supplement plan outside of an enrollment period:
- Medical Underwriting: Outside of an enrollment period, insurance can look at your medical history to determine what coverage they offer. They may even require you to get a physical, which can be an added hassle.
- Higher Premiums Based on Health: If medical underwriting finds you have a pre-existing condition, the insurance company can charge you more on your premiums.
- Limited Plan Options: Insurance companies can limit plan options outside of open enrollment. You might find the plan you wanted is not available to you.
- Coverage denial: If insurance companies determine you’re too high of a risk, they may refuse to offer you coverage altogether.
How to Enroll In a Medicare Supplement Plan
Enrolling in a Medicare Supplement plan is relatively straightforward if you do it during an enrollment period. Use these steps to help you get started.
- Evaluate your coverage needs: Take a look at your medical bills from the last year. You might benefit from a Medigap plan that covers your Part A deductible and coinsurance if you had multiple hospital stays. If you expect to go to the doctor often in the coming year, consider a plan that provides good Part B coinsurance coverage.
- Compare your Medigap plan options: Depending on where you live, how old you are, and what enrollment period you’re in, you can have up to 10 Medigap plans to choose from. After you’ve narrowed down the plan you want, you have to browse the available policies from different insurance providers. It’s a lot to consider. For help comparing your options, consider partnering with a trusted Medicare agent.
- Gather the necessary documents for applying: To apply, you need your Medicare number, Social Security number, and proof of age and birthday.
- Select your preferred Medigap plan and follow the enrollment process: Each insurance provider has a slightly different application process. Usually, it involves filling out an application with your personal information.
- Undergo medical underwriting or survey, if required: If you’re enrolling outside of open enrollment, the insurance company checks your health history to see what to charge you for your monthly premiums.
- Await application acceptance or denial results, if applicable: You cannot be denied coverage in open enrollment. However, outside that time, the insurance company may deny coverage based on medical underwriting results.
- Receive confirmation of Medicare Supplement coverage: Once you’re approved, you receive a copy of your Medigap policy. Coverage usually begins the first month after you apply.
Changing Medigap Plans
If you need to change Medigap plans, perform the following steps:
- See if you’re eligible for a switch: Every Medigap plan comes with a 30-day free look period. If you’re unhappy with your chosen plan, you have 30 days to move to a new one. You do need to pay both premiums for one month if you switch.
- Browse your plan options: You can choose from any plan if you’re still in your 6-month open enrollment period. If you’re not, you might have limited options. Make sure to consider why you want to switch plans.
- Choose your new plan and enroll: The insurance company might ask you to submit an application or go through medical underwriting.
- Cancel your old policy once you’re accepted: Make sure to cancel your old policy, so you’re not paying double each month.
Enrolling in Medigap When You’re Under 65
If you have a specific disability or end-stage renal disease, you might be eligible for a Medigap policy when you’re younger than 65. However, it depends on where you live. No federal law requires insurance companies to sell policies to people under 65. Currently, 33 states allow you to enroll in Medigap as long as you’re eligible for Medicare. Check with your state’s regulations to see if you meet the requirements.
Putting It All Together
Medigap Supplement plans are an excellent way to reduce some of your healthcare costs. They supplement Medicare’s coverage to help lower your out-of-pocket expenses. Enrolling in a plan can be worthwhile if you do it at the right time.
Take advantage of your initial enrollment period to get lower costs and more plan options. If you cannot pick a plan during this 6-month window, you might be able to enroll during a special enrollment period or birthday rule period depending on where you live. If you need more help deciding when and how to choose a Medigap plan, contact a knowledgeable Medicare agent for more support.