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Guide to Changing Your Medicare Supplement Plan

When Can You Change Your Medicare Supplement Plan?

Those looking to change their Medicare Supplement plan can do so at any time throughout the year, though you may have more options or potentially lower premiums if you enroll during one of the following times:

  • Your individual Medigap open enrollment period, also known as the initial enrollment period
  • Your Medigap “Birthday Rule” period, if your state offers it
  • Your state’s Medigap Annual Enrollment Period, if your state offers it
  • Other state-specific enrollment criteria periods, if your state offers it

Medigap does not follow the same enrollment periods as Original Medicare.

Follow Enrollment Periods for Medigap

Unlike Original Medicare, there is not a national annual enrollment window for changing your Medicare Supplement insurance. Instead, changes to Medicare Supplement plans — also known as Medigap — can be made at any time throughout the year, though your health history and status could affect your plan premium and available options. However, some states may offer their own specific windows for plan changes, where you can make changes without your health status being factored in. Learn when and how you can change your Medicare Supplement plan.

Medigap Open Enrollment, or Initial Enrollment Period

Your Medigap open enrollment window, or Initial Enrollment Period, lasts for 6 months after you turn at least 65 years old and enroll in Medicare Part B. When you enroll during this period, you will not have to undergo medical underwriting, which means your current health status and your health history will not impact your Medigap plan options or premium cost.

Medicare Supplement “Birthday Rule” Periods

The Medicare Supplement “Birthday Rule” is a yearly enrollment period that allows Medigap holders to change their plan without medical underwriting. However, only 6 states observe the birthday rule:

State
Birthday Rule Enrollment Period
30 days from birthday to change to a different Medigap plan with similar or fewer coverage
63 days from birthday to change to a different Medigap plan with similar or fewer coverages
60 days from your birthday to change to a different Medigap plan with the same or fewer coverages
45 days after your birthday to change to any plan offered in the state with the same or fewer coverages
61 days, starting from the first day of your birth month to change to a different Medigap plan with similar or fewer coverages
31 days, beginning on your date of birth to change to a different Medigap plan with similar or fewer coverages

This annual enrollment period only allows for changes to existing Medigap plans, which means you cannot use it to sign up for Medigap for the first time without medical underwriting. You also cannot use this period to change to a plan with more benefits than your current plan without your health status and history impacting your options and premiums.

Medicare Supplement Continuous or Annual Enrollment Periods

Four states have continual or annual Medigap enrollment periods that prohibit insurers from denying coverage, even to those with pre-existing conditions:

Beneficiaries in these states can change their plan at any time throughout the year without consequence, though there may be state-specific criteria. For example, to switch plans at any time throughout the year, Maine residents must have maintained continuous Medigap coverage with no lapses in coverage exceeding 90 days since their initial enrollment period.

Some insurers in these states may also uphold “waiting periods” for coverage in recently purchased plans, which means coverage may not kick in until a certain number of days has passed since you switched to that new plan.

The Medigap annual enrollment period should not be confused with the wider-reaching Medicare Annual Enrollment Period (AEP). Though the terminology is similar, the Medigap annual enrollment period only applies to Medicare Supplement plans; the Medicare AEP follows different rules and only applies to Original Medicare and Medicare Advantage plans.

Other State-specific Periods

Other states have their own Medicare Supplement enrollment periods and rules that allow someone to change plans with guaranteed issue rights, which means all Medigap options must be made available to them and their health cannot impact their premiums. For example, in Washington, those enrolled specifically in Medigap Plan B, C, D, F, G, K, L, M, or N can switch to another B through N plan at any time.

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

What Are Guaranteed Issue Rights?

Medigap “guaranteed issue rights” allow you to change your Medigap plan without undergoing underwriting, meaning your past and present health status cannot impact your plan options or premium. 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 available for anyone who is enrolling in Medigap during their initial enrollment period. Outside of this period, it is only available under specific circumstances, such as the enrollment windows mentioned earlier.

Guaranteed issue rights apply to you if:

  • Your Medicare Supplement plan can no longer cover you. This includes situations where your plan leaves the Medicare system, stops providing care in your area, or if you move out of the plan’s service area. You will need to enroll in another plan during a period that begins 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, but want to switch back after less than a year. 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. In this scenario, you will need to apply within 63 days of the end of your coverage.
  • You leave a Medicare Advantage plan or canceled your current Medigap policy because the insurer misled you. In this scenario, you will need to apply within 63 days of the end of your coverage.

If you switch policies outside your state’s applicable Medigap window and you are not eligible for guaranteed issue rights due to at least one of the scenarios listed above, you will likely undergo medical underwriting. This typically includes a medical exam and questionnaire. The results can lead to higher premiums, fewer plan options, or even denial of coverage overall.

Why Consider Changing Medicare Supplement Plans At All?

Plan benefits are standardized based on the plan type. For example, all Medigap Plan A benefits are the same no matter which insurer you get it from. However, you may want to change your current Medigap plan to a different plan type, like Plan A to Plan M, or switch to a different insurer who may offer a lower premium.

Even though changing Medical Supplement plans can sometimes result in medical underwriting, it can still be a valuable decision. Some reasons to consider switching plans include:

  • Get 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.
  • Increase benefits coverage. You need more coverage than your current Medigap plan provides, so changing to a more comprehensive plan may help you save more in health care costs long term.
  • Decrease benefits coverage. If you have a comprehensive plan but find yourself rarely utilizing the benefits, you could save money by changing to a plan with fewer benefits. You would stop paying for coverage that you do not need, resulting in a lower premium.
  • Change insurance companies. Many insurance companies offer Medicare Supplement plans, so if you are unhappy with your current insurer, it may be in your best interest to change to another. For example, if you find the customer service lacking, you may have a better experience with a different insurance company even if you stay with the same Medigap plan type.
  • Adjust to match your budget. Changing your benefits level up or down to reflect an increase or decrease in your budget can ensure you continue to get the best coverage that you can comfortably afford. It is important to re-evaluate your Medicare Supplement plan periodically to make sure it still meets your needs.

When possible, switch plans during an enrollment window that allows you guaranteed issue rights to get the most options and most favorable premium. But whether you switch Medigap plans with or without guarantee issue rights, it is critical to thoroughly research the potential outcome of any policy change before committing to the change. For example, ensure you thoroughly understand the benefits coverage, costs to keep the plan active, and any fees that may be associated with changing plans.

Is Changing Your Medicare Supplement Plan Risky?

Even though changing your Medigap plan can be a good choice for you, there are some risks associated with switching coverage. Things to consider as you change Medicare Supplement plans include:

  • Make sure you understand how your benefits will change from one Medigap plan type to another. Changing to a plan with fewer benefits means that you may not have as much coverage as you did before, such as changing from Plan C to Plan A.
  • Pick an insurance company with a good reputation. Doing this will help reduce your chances of signing up with an insurer who could go out of business or who provides subpar customer service when you need it. While the risk of an insurance company going out of business is minimal, it does happen from time to time. However, if this does happen, you would be eligible for a special enrollment window that allows you to change to another Medigap plan with guaranteed issue rights.
  • You may decide you actually prefer your old plan or insurer to the new one. Even if the new plan sounded right at the time, you may decide that the old one suited you better. If this happens and you are still within your “free look” period, you may change back to your old one without having to reapply. The “free look” period is a 30-day window where you maintain coverage for both your old and new Medigap plan, allowing you to compare the new plan to your old one for 30 days before completely canceling the old one.

How Do You Change Medicare Supplement Plans?

Even if you have determined when you will change plans, it may be beneficial to work with a licensed insurance agent to help guide you through actually making the change. However, you may also do this on your own. Research the insurers and plan options available to you, comparing premiums, looking at each insurer’s reputation for customer satisfaction, and whether the plan offers the benefits you would like to have.

Once you’ve decided on an insurer and Medigap plan type, you may submit an application. If you were not exempt from medical underwriting based on any of the reasons stated earlier, your application process will include a health questionnaire and medical examination. The questionnaire may be completed over the phone, and you will work with the insurer to make an appointment with a health care professional for the exam.

If your application for the new policy is accepted, you can then call your old insurance company and cancel your old plan following their cancellation procedure. This may include submitting your cancellation in writing. However, before formally canceling your old Medigap plan, you may want to keep it active for 30 more days to take advantage of a “free look” period.

What is the Medicare Supplement “Free Look” Period?

All Medigap plans come with a “free look” period, which allows you 30 days once you enroll in a Medigap plan to decide whether or not you want to keep your new policy. This period starts when you get your new Medicare Supplement plan.

Keep in mind that you will need to pay the premium for both your old and new plan during this 30-day window to be eligible for the “free look” period. However, you may decide that you like your old plan better during this time. With the “free look” period, you can switch back and cancel your new plan within those 30 days without penalty. However, if you do not change your mind until after the 30-day “free look” period, you will have to reapply to change plans again.

 

Your Next Steps

  • Check if your state offers a Medigap “Birthday Rule,” annual or continuous enrollment period, or other state-specific criteria that will let you change plans with guaranteed issue rights.
  • See if your reason for changing Medigap plans makes you eligible for guaranteed issue rights, which could increase your plan options and keep premiums lower.
  • When changing plans, stay enrolled in your old plan too for at least 30 days to take advantage of the “free look” period.

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