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Medicare

When Can You Change Your Medicare Supplement Plan?

While you can technically change your Medicare Supplement plan at any time, there are some crucial caveats you’ll want to be aware of before pulling the trigger. Moving forward without these crucial details could cost you time and money, and even result in denied coverage. Read on to learn more.

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Medicare Supplement (also known as Medigap) Plans fill gaps in coverage that may appear in your existing Medicare Plan, such as copays, deductibles, and coinsurance. Since Medigap plans are uniform, the most common reason to consider changing your current plan is to save money through a lower premium. However, given that Medicare utilizes standardized periods to enroll or alter coverage, you may be curious about the best time to make the change. Read on to learn more.

When Can You Change Your Medicare Supplement Plan?

Private insurers sell Medigap to supplement Original Medicare or Medicare Advantage. You can change your Medigap at any time. However, if you’d prefer to avoid undergoing medical underwriting, you’ll want to enroll or change your plan during the Medigap Open Enrollment Period.

Medigap Open Enrollment occurs within six months of enrolling in Medicare Part B and becoming 65 years old. If you can register a new plan during this period, you will not have to undergo medical underwriting. You can also change plans without underwriting if you qualify for Medigap guaranteed issue rights.

If you don’t qualify for guaranteed issue rights, you can still try to change or enroll in a Medigap Policy. Because the plans are sold by private insurers and involve underwriting, you may be turned down for coverage or provided a quote with unaffordable premiums.

Therefore, if you are reluctant to go through underwriting, consider the following options.

Medicare Supplement “Birthday Rule” Periods

The Medicare Supplement “Birthday Rule” is a yearly open enrollment period allowing Medigap holders to change their plan without undergoing medical underwriting. Only six states observe the birthday rule–California, Oregon, Idaho, Nevada, Illinois, and Louisiana–and each offers it with distinct rules and regulations.

This yearly enrollment period generally occurs immediately before and after the beneficiary’s birthday. You typically cannot sign up for Medigap with birthday rule benefits if you don’t already have it and cannot change to a plan with more coverage.

Medicare Supplement Continuous or Annual Enrollment Periods

Four states have continual or annual Medigap enrollment periods prohibiting insurers from denying coverage, even those with pre-existing conditions. Beneficiaries in New York, Connecticut, and Massachusetts can change their plan at any time without consequence, while beneficiaries in Maine have this opportunity one recurring month per year. Some insurers in these states may still uphold “waiting periods” for coverage in recently purchased plans, should pre-existing conditions be a factor.

The Medigap annual enrollment period linked to the states above should not be confused with the wider-reaching Medicare Annual Enrollment Period (AEP). Medigap follows different rules than general Medicare and does not participate in AEP.

Other State-specific Periods

Other states have their own Medicare Supplement Enrollment periods that allow someone to change plans with guaranteed issue rights. For example, if you are already enrolled in any Medigap Plan B through N in the state of Washington, you can switch at any time to another B through N plan.

In Missouri, you have the right to switch companies once per year during the 30 days preceding and following your policy’s anniversary date. The new insurer cannot deny you coverage nor impose a waiting period in light of pre-existing conditions.

What Are Guaranteed Issue Rights For Medicare Supplement Plans?

Medigap “guaranteed issue rights” allow you to change your Medigap plan without undergoing underwriting. This is especially important if you have any pre-existing conditions (e.g., heart disease, diabetes) that would otherwise result in you being denied coverage.  

Guaranteed issue rights are only available under specific circumstances. If you try to switch policies outside your Medigap open enrollment period and don’t qualify for any guaranteed issue rights, you will likely have to proceed through medical underwriting. Medical underwriting can lead to higher premiums and even denial of coverage.

Guaranteed Issue Rights apply to you if:

  • Your Medicare Advantage Plan is leaving the Medicare system, stops providing care in your area, or you move out of the plan’s service area. You will need to enroll in the period between the 60 days before the end of the plan and 63 days following its conclusion.
  • You have Original Medicare and either an Employer Group Plan or Union Coverage that is ending. In this situation, you must apply within 63 days of either the end of coverage, the date of the notice that informs you the plan is ending, or the date of a claim denial that informs you of the end of the plan.
  • You have Original Medicare and a Medicare Select Plan and move out of the Medicare Select policy’s coverage area. You will need to enroll in the period between the 60 days before the end of the plan and 63 days following its conclusion.
  • You joined a Medicare Advantage plan or program of All-Inclusive Care for the Elderly (PACE) when you initially became eligible for Medicare and want to switch to Original Medicare. You will need to enroll in the period between the 60 days before the end of the plan and 63 days following its conclusion.
  • You dropped a Medigap policy to join a Medicare Advantage Plan, you’ve been in the plan less than a year and want to switch back. You will need to enroll in the period between the 60 days before the end of the plan and 63 days following its conclusion.
  • Your Medigap Insurance company goes out of business, and you lose your coverage. In this scenario, you will need to apply within 63 days of the end of your coverage.
  • You leave a Medicare Advantage plan or cancel your Medigap Policy because the insurer misled you. In this scenario, you will need to apply within 63 days of the end of your coverage.

Why Should You Consider Changing Medicare Supplement Plans?

Even though changing Medical Supplement plans can sometimes result in medical underwriting, it can still be valuable depending on your situation. Some of the reasons to switch include the following:

  • You can find better rates. Once a year, insurance companies must send out a Medicare Annual Notice of Change, highlighting rate fluctuations. If your rates go up, you can shop for a similar plan within the same company or seek a better deal elsewhere.
  • You need more coverage than your current Medigap plan provides.
  • You are paying for coverage that you don’t need. If this is the case, you can switch to a more basic plan with a lower premium.
  • You are unhappy with your provider. Many private insurance companies offer Medicare Supplement Plans, and with some research, you are bound to find one that suits your needs. 
  • There’s a change in your financial situation
  • Your old insurance is no longer available.

A few of these scenarios may qualify you for guaranteed issue rights, while others will not. Even if you can find a better deal, it is critical to thoroughly research the potential outcome of any policy change before pulling the trigger.

How Do You Change Medicare Supplement Plans?

If you have not decided upon a new Medicare Supplement plan, you may want to find a licensed insurance agent to help guide you through your options. Once you’ve decided, apply for your new Medigap plan. Suppose you aren’t exempt from medical underwriting based on any of the reasons stated earlier. In that case, you will need to answer a few questions about your health over the phone and participate in a thorough medical examination.  

If your application for the new policy is accepted, call your old insurance company and cancel your old plan in writing. The insurance company will not do this for you on their own. Take advantage of your “free look” period before cancellation, should you feel it necessary.

What is the Medicare Supplement “Free Look” Period

All Medigap plans come with a “free look” period, allowing you 30 days to decide whether or not you want to keep your new policy. This period starts when you get your new Medicare Supplement plan, and you’ll need to pay the monthly premium on both your old and new plans to qualify. If you like your old plan better, you can switch back and cancel your new plan within 30 days. However, if you change your mind after the free look period, you will have to reapply and undergo medical underwriting.