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Medigap Enrollment Periods

The ideal time to sign up for a Medicare Supplement plan is during the Open Enrollment period, which lasts for 6 months. If you try to enroll in Medigap outside of this period, there’s no assurance that you’ll qualify for a Medigap policy if you don’t meet the medical underwriting criteria. However, certain circumstances make you eligible to enroll outside of the Open Enrollment period.

Medigap Open Enrollment Period

Your Medigap Open Enrollment Period is a special time when you can select any Medicare supplement plan without undergoing medical underwriting. This enrollment period occurs only once in your lifetime and is the most favorable time to enroll in a Medicare supplement plan. Although you can enroll in the future, you’ll have to go through medical underwriting, and your health history may result in a denial of coverage.

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 submit an application outside of your open enrollment period, the insurance company may require you to undergo medical underwriting before allowing you to join a plan. Even if you pass the underwriting, the insurer may decide to charge you a higher monthly premium based on any pre-existing medical conditions you have.
  • Many people confuse this enrollment period with the Annual Enrollment Period (AEP), which is only for Medicare Advantage (Part C) and Part D plans. The AEP takes place every year from October 15 to December 7.
  • For individuals turning 65, their Open Enrollment Period starts on their Part B effective date and lasts for six months. This also applies if they opted to delay enrollment in Part B because they had other creditable health coverage.

Planning for Your Open Enrollment Period

Individuals who initiate the Medicare enrollment procedure early will receive their Medicare ID card before their 65th birthday month. This is advantageous for planning ahead for their Open Enrollment Period, as having their Medicare ID enables them to submit a Medicare supplement application prior to their Part B effective date. Doing so allows their coverage to start at the earliest possible time.

Furthermore, submitting an application early can be beneficial as it locks in the individual’s rates. Since rates for Medicare supplements frequently change (typically increasing), submitting an application as soon as possible ensures that the individual gets the best rate possible.

Second Open Enrollment Periods

As previously mentioned, the Medigap Open Enrollment Period typically occurs only once in an individual’s lifetime. However, there is one situation where an individual may have two open enrollments during which they can select any Medigap plan without answering health-related questions.

Individuals who qualify for Medicare due to a disability and are below the age of 65 usually have limited options when it comes to selecting a Medicare supplement. Typically, Plan A is the only option available, which provides only the most basic health benefits. As Plan A can be twice or thrice as costly for those below 65, many individuals in this category opt not to enroll in coverage.

When these individuals turn 65, they are granted a second Open Enrollment Period and can choose any available plan. The rates for these individuals will be the same as those for any other 65-year-old, and their disability cannot be used to increase their rates.

Take Advantage of Your Medigap Open Enrollment Period

Medicare beneficiaries are often subject to higher healthcare costs, which makes finding comprehensive and affordable coverage crucial. The ideal solution is to obtain excellent coverage at a competitive rate. To achieve this, it is advisable to apply for a Medicare supplement plan during the open enrollment period. Doing so ensures that you obtain great rates and that you have the necessary coverage for both the present and the future.

When to Enroll in a Medicare Supplement

You have the option of enrolling in a Medicare supplement plan at any point in the year if you are eligible for Medigap. However, if you enroll outside of your Open Enrollment Period, you will be required to answer questions regarding your health history, and your insurance carrier may deny coverage based on your answers. The only way to avoid medical underwriting is if you qualify for a Special Enrollment Period.

It is important to note that certain states have their own unique rules regarding open enrollment and guaranteed issue rights. For example, California and Connecticut have distinct regulations. In California, there is a birthday rule that allows you to enroll in a Medigap plan around the time of your birthday each year, without having to pass medical underwriting. Connecticut has year-round open enrollment for all Medicare beneficiaries, and medical underwriting is not necessary.

Comparing the Open Enrollment Period & the Annual Enrollment Period

The terms Medigap Open Enrollment Period and Annual Enrollment Period are often used interchangeably, but they refer to distinct enrollment windows that are critical for Medicare beneficiaries. While we have already covered the Medigap Open Enrollment Period, let’s now focus on the Annual Enrollment Period (AEP). The AEP occurs annually from October 15th to December 7th, during which time Medicare beneficiaries can make changes to their Part C and Part D plans. They can join, switch, or disenroll from these plans, with the changes taking effect on January 1st of the following year. Since Part C and Part D plans change annually, the AEP is a crucial window for those enrolled in these plans. While Medicare Advantage plan members can switch back to Original Medicare and select a Medigap policy during AEP, there are no guaranteed issue rights associated with this period. Therefore, they may need to pass medical underwriting to be eligible for Medigap coverage.

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