Changing or Switching Medigap Plans: Enrollment Guide
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You can change your Medicare Supplement (Medigap) plan or switch to Medigap at any time.
But if you want a good deal, we recommend that you only change your Medigap plan or sign up for a new plan when you have enrollment protections called "guaranteed issue." This will prevent you from paying higher rates because of your medical history.
You could qualify for Medigap enrollment protection in situations such as moving or losing other insurance coverage. But most Medigap enrollment protections vary by location. For example, in California, you can change Medigap plans annually because of the state's expanded regulations, but other states may not offer as much flexibility.
About Medigap protected enrollment
When you have the enrollment protections of Medigap "guaranteed issue":
- Your policy application can't be turned down because of a health condition, your age, your gender or other influencing factors. Essentially, you are guaranteed to get a Medicare Supplement plan.
- You can't be charged more for a Medigap plan than the standard rates for your age group. This means you won't have to complete a health questionnaire or go through medical underwriting, which can sometimes cause rates to double.
- You won't have a waiting period for preexisting conditions. The full policy benefits would begin immediately instead of an insurer temporarily not covering an existing illness.
The rules about Medigap guaranteed issue apply to any type of Medigap coverage change. This includes changing plans, changing insurers, switching from Medicare Advantage to Medigap or late enrollment in a new Medigap plan.
Changing your Medigap plan at any time
You can apply for a new Medigap plan or apply to change your coverage at any time, even after your Medigap initial enrollment period.
However, those who have preexisting conditions may find that plans are expensive or unavailable without the protections of Medigap guaranteed issue. This is because you'll go through the medical underwriting process where an insurer assesses your health, your age and other factors to determine how much you should pay for a plan.
If you think you may want to choose a Medigap policy at some point during your senior years, it's often a good idea to enroll in a Medicare Supplement plan at age 65 during your initial Medigap enrollment period and then keep the plan for the long term. During this time, everyone in the country has protected enrollment, and factors like your health history won't be considered.
There is no risk in requesting a Medigap quote, and this process can help you understand what a plan might cost. Each insurance company has different criteria for how your medical history affects prices, so the Medigap quotes you receive can vary widely. Remember you can't be enrolled in a Medicare Advantage plan at the same time you're enrolled in Medigap or Medicare Part D.
When considering the cost of a Medigap plan, keep in mind that options like Medigap Plan G will eliminate most medical expenses. Depending on your health and financial situation, it may be worth it to pay a few hundred dollars per month for coverage in order to avoid most medical bills.
After you have a Medicare Supplement plan, an insurer can't terminate your policy because of a health condition. However, rates could change annually.
Federal rules on changing Medigap plans
The federal regulations only let you change or switch Medigap plans with protections from higher rates if you move, if you lose other coverage or if it's your first year of coverage.
Below are the specific situations when you'll have protected Medigap enrollment to avoid the risk of higher rates or being turned down if you want to change your plan or switch from Medicare Advantage to Medigap.
Moving
- If you move outside of a Medicare Advantage plan's service area
- If you move outside of a Medigap Select plan's service area
Other coverage is ending
- If your Medicare Advantage plan stops providing coverage in your area
- If your other type of coverage is ending (employer health plan, retiree plan, COBRA, union plan)
- If your Medicare Advantage plan leaves Medicare
- If your Medigap company goes bankrupt
- If your Medigap or Medicare Advantage coverage ends through no fault of your own
- If your Medigap or Medicare Advantage plan hasn't followed the rules or has misled you
During your first year of coverage
- Free look period (30 days after Medigap enrollment): After purchasing a Medigap plan, you have 30 days to decide if you want to switch to a different Medigap plan or company.
- Trial right period (one year after enrolling in Medicare Advantage): You have a one-year trial period after initially purchasing a Medicare Advantage plan or switching from Medigap to Medicare Advantage. During this time, if you decide you'd rather have a Medigap plan, you are protected from a rate increase or being turned down when you switch. If you previously had Medigap, you'll usually only have enrollment protections if you return to the same Medigap policy you had.
- Trial right period (one year after enrolling in Medigap Select): You also have a one-year trial period with Medigap Select plans, which are a type of supplemental plan that has a limited network of providers. During your first year of coverage, you'll have guaranteed issue to switch to a standard Medigap plan.
You won't qualify for these protections if you lost coverage because you stopped paying your monthly premiums or if your plan was canceled because you weren't truthful on the policy application.
Even when you qualify through one of the above circumstances, you can only switch to Medigap Plan A, B, C, D, F, G or K. This excludes Plans M and N, two options that provide reasonably good coverage for moderate costs.
It's also important to consider the timing to ensure you have continuous coverage. In many cases, your enrollment period lasts for about four months — starting 60 days before and ending 63 days after your other coverage ends.
For those who are switching from Medicare Advantage to Medigap, these Medigap guaranteed issue circumstances simultaneously qualify you for a Medicare Advantage special enrollment period, which allows you to drop your current Medicare Advantage plan.
State rules about changing Medigap plans
In 41 states, consumers have more opportunities for protected enrollment in a Medicare Supplement plan because of expanded guaranteed issue rights.
While this expanded access can give you more flexibility, regulations can vary widely between states, making it important to check your local rules. Depending on the regulations in your state, you may be able to switch between two Medigap plans to change your coverage, switch between two insurers to get better rates or, in some cases, switch between Medicare Advantage and Medigap.
There are 12 states with annual or continuous Medigap guaranteed issue, as of 2022, so you'll have the most enrollment flexibility in:
- California
- Connecticut
- Idaho
- Illinois
- Maine
- Massachusetts
- Missouri
- Nevada
- New York
- Oregon
- Rhode Island
- Washington
Additionally, there are also 34 states where those who qualified for Medicare because of a disability will have access to at least one Medigap plan, providing options for coverage before age 65. Without this regulation, those who qualified for Medicare because of a disability may not be able to enroll in a Medigap plan until they turn 65.
Below are the Medigap guaranteed issue rights by state.
- Medicaid: If you become eligible for Medicaid, you can pause your Medigap coverage for up to 24 months and reinstate the plan within 90 days of losing Medicaid eligibility.
- Medicaid: If you become eligible for Medicaid, you can suspend a Medigap plan for up to 24 months and reinstate it within 90 days of losing Medicaid eligibility.
- Alaska Comprehensive Health Insurance Association (ACHIA): If you were turned down for Medigap because of a preexisting condition or you qualified for Medicare because of a disability, you may be eligible for a Medicare supplemental policy through ACHIA. These plans are usually more expensive than what you can get when you have guaranteed issue during initial enrollment. However, the plans are cheaper than what's usually offered if you go through medical underwriting.
- There are no Medigap guaranteed issue protections in Arizona beyond federal requirements.
- Disability: Those who qualify for Medicare because of a disability have a protected enrollment period during the six months after becoming eligible for Medicare, rather than needing to wait until age 65. During this time, plan applications can't be denied because of a health condition. Plus, insurers are required to offer at least one Medigap plan to those under age 65.
- Switch to another Medigap plan on your birthday: If you already have Medigap, you have a 30-day window each year starting on your birthday when you can change to another Medigap company or plan if you select one that has the same or fewer benefits. This allows you to change your benefits or choose a company that has cheaper rates for your plan letter.
- Changes in Medicare Advantage costs: If your Medicare Advantage plan increases your monthly rates or increases your portion of medical costs, you have guaranteed issue in California to switch to a Medigap plan offered by the same insurance company. If the insurance company doesn't sell Medigap plans and your costs increase more than 15%, you can enroll in a Medigap plan from any insurance company. Keep in mind that Medicare Advantage rates often change annually, so most people in California can use this provision to switch to a Medigap plan during fall open enrollment.
- Changes in Medicare Advantage plan benefits or doctors: If your Medicare Advantage plan reduces its benefits or a medical provider who is currently treating you is no longer in the network, you can switch to a Medigap plan from the same insurance company. And if that's not available, you can choose a Medigap plan from any insurance company.
- Reduced coverage from a retiree plan: In addition to having the federally mandated guaranteed issue if you lose retiree coverage, you also have guaranteed issue in California if your retiree plan decreases the benefits it provides such as no longer paying Medicare Part B coinsurance costs.
- Medi-Cal: If you lose full Medicaid benefits, you are eligible for Medigap open enrollment, which gives you guaranteed issue enrollment protections. Also, if you become eligible for Medi-Cal, you can suspend a Medigap plan for up to 24 months and reinstate it within 90 days of losing Medicaid eligibility.
- Disability: Those who qualify for Medicare because of a disability are eligible for two guaranteed issue periods. The first occurs during initial enrollment in the six-month period after signing up for Part B, and the second occurs during the six-month open enrollment period after turning 65. This doesn't apply to those under age 65 who qualified for Medicare because of kidney failure (also called end-stage renal disease).
- Problems with getting care through Medicare Advantage: If your Medicare Advantage plan substantially fails to provide you with timely and medically necessary care based on the plan's benefits, you qualify for guaranteed issue in Colorado to switch to a Medigap plan.
- Medicaid: If you become eligible for Medicaid, you can suspend a Medigap plan for up to 24 months and reinstate it within 90 days of losing Medicaid eligibility.
- Disability: Those under 65 who qualified for Medicare because of a disability have a guaranteed issue period during the six months after signing up for Part B. Even though the cost for a plan is usually higher than what a 65-year-old pays, the state limits how much insurance companies can charge.
- Continuous guaranteed issue: At all times, those in Connecticut over age 65 have guaranteed issue to enroll in a Medigap plan.
- Disability: Those who qualify for Medicare because of a disability can enroll in Medigap Plans A, B, C (if eligible for Medicare before 2020) and D.
- Disability: Those under 65 who qualified for Medicare because of a disability in Delaware have guaranteed issue during the six-month period after signing up for Part B. However, the cost for a plan is usually higher than what a 65-year-old pays.
- Disability: In Florida, those under 65 who qualified for Medicare because of a disability have Medigap guaranteed issue during the six months after signing up for Part B. There's a second Medigap open enrollment period when the individual turns 65 to access the generally lower rates that are offered to seniors.
- Medicaid: If you become eligible for Medicaid, you can suspend a Medigap plan for up to 24 months and reinstate it within 90 days of losing Medicaid eligibility.
- Problems with getting care through Medicare Advantage: If your Medicare Advantage plan doesn't provide you with essential and medically necessary care in a timely way based on the plan's benefits, you qualify for guaranteed issue in Georgia to switch to a Medigap plan.
- Disability: Insurance companies in Georgia are required to offer at least one Medigap plan to those under age 65 who are enrolled in Medicare, but there are no protections in the state's rules and regulations about guaranteed issue.
- Disability: Those under 65 who qualified for Medicare because of a disability cannot be denied a Medigap policy during the six-month period after signing up for Part B.
- Switch to another Medigap plan on your birthday: If you already have Medigap, you have a 63-day window starting on your birthday when you can change to another Medigap company or plan, if you select one that has the same or fewer benefits.
- Problems with getting care through Medicare Advantage: If your Medicare Advantage plan substantially fails to provide you with timely and medically necessary care based on the plan's benefits, you qualify for guaranteed issue in Idaho to switch to a Medigap plan.
- Disability: Those under 65 who qualified for Medicare because of a disability in Idaho cannot be denied a Medigap policy during the six-month period after signing up for Part B. Plan costs are capped at 50% higher than the rates for those who qualified for Medicare because of their age. However, at age 65, those who qualified because of a disability can access the lower rates that other 65-year-old enrollees pay.
- Blue Cross Blue Shield (BCBS) of Illinois: BCBS offers guaranteed issue Medigap plans to anyone age 65 or older. You can enroll at any time, you won't be denied coverage because of a health condition, and costs are the same as those for anyone in the same policy class.
- Disability: Those under 65 who qualified for Medicare because of a disability cannot be denied a Medigap policy during the six-month period after signing up for Part B. However, the costs for a plan are usually higher than what seniors pay. After this initial Medigap enrollment period, you'll still have guaranteed issue to purchase a Blue Cross Blue Shield plan each fall from Oct. 15 to Dec. 7, or to purchase a plan from any company during another six-month open enrollment period when you turn 65.
- Medicaid: If you become eligible for Medicaid, you can suspend a Medigap plan for up to 24 months and reinstate it within 90 days of losing Medicaid eligibility.
- There are no Medigap guaranteed issue protections in Indiana beyond federal requirements.
- There are no Medigap guaranteed issue protections in Iowa beyond federal requirements.
- Disability: Those under 65 who qualified for Medicare because of a disability cannot be denied a Medigap policy during the six-month period after signing up for Part B.
- Medicaid: If you lose Medicaid coverage in Kansas, you have guaranteed issue to enroll in a Medigap plan up to 63 days after your coverage ends.
- Disability: Insurance companies are required to offer at least one Medigap plan to those under age 65 who are enrolled in Medicare, but there are no protections in the state's rules and regulations about guaranteed issue.
- Problems with getting care through Medicare Advantage: If your Medicare Advantage plan substantially fails to provide you with timely and medically necessary care based on the plan's benefits, you qualify for guaranteed issue in Louisiana to switch to a Medigap plan.
- Medicaid: If you become eligible for Medicaid, you can suspend a Medigap plan for up to 24 months and reinstate it within 90 days of losing Medicaid eligibility.
- Disability: Those under 65 in Louisiana who qualify for Medicare because of a disability have a six-month guaranteed issue period when they first become eligible for Medicare.
- Annual guaranteed issue: For one month per year, insurers are required to offer Medigap Plan A with guaranteed issue enrollment protections. The insurance company chooses the month, so when you have access varies based on the insurance company.
- Continuous guaranteed issue: Medicare Plan A is offered with guaranteed issue protections all year long from companies such as Anthem Blue Cross Blue Shield, Colonial Penn Life and Washington National.
- Downgrade coverage or change insurers: At any time, you'll be guaranteed to be issued a new policy as long as the plan you select has the same or fewer benefits.
- Disability: Those under 65 who qualified for Medicare because of a disability have a guaranteed issue period when they first become eligible for Medicare, and a second guaranteed issue period when they turn 65.
- Losing other coverage: Guaranteed issue is also available for those who lose coverage through an individual health insurance plan or MaineCare.
- Disability: Insurers that offer Medigap Plans A and D must also provide the two plans to those who qualified for Medicare because of a disability during a six-month initial enrollment period. A plan application can't be denied, but rates for those under 65 are higher than what seniors pay. For example, Plan D from State Farm or Colonial Penn costs about $550 per month.
- Medicaid: If you become eligible for Medicaid, you can suspend a Medigap plan for up to 24 months and reinstate it within 90 days of losing Medicaid eligibility.
- Continuous enrollment: In Massachusetts, all Medicare enrollees have continuous open enrollment for a Medigap plan from any company. That means you can sign up at any time without risking higher costs for late enrollment or your application being denied. This guaranteed issue protection doesn't always include add-on policies such as dental coverage or a preventive care rider.
- Disability: Those who qualified for Medicare because of a disability have the same continuous rights to guaranteed issue Medigap.
- Disability: Insurance companies are required to offer at least one Medigap plan to those under age 65 who have Medicare because of a disability or health condition. However, the state's rules and regulations do not specify any guaranteed issue protections for those under age 65. That means that plans are available, but you may still need to go through medical underwriting to qualify.
- Medicaid: If you become eligible for Medicaid, you can suspend a Medigap plan for up to 24 months and reinstate it within 90 days of losing Medicaid eligibility.
- Problems with getting care through Medicare Advantage: If your Medicare Advantage plan substantially fails to provide you with timely and medically necessary care based on the plan's benefits, you qualify for guaranteed issue in Minnesota to switch to a Medigap plan.
- Disability: Those under 65 who qualified for Medicare because of a disability in Minnesota have a guaranteed issue period during the six months after first enrolling in Medicare Part B.
- Medicaid: If you become eligible for Medicaid, you can suspend a Medigap plan for up to 24 months and reinstate it without going through medical underwriting.
- Disability: Those under 65 in Mississippi who qualified for Medicare because of a disability have a guaranteed issue period during the six months after first signing up for Part B. There's a second six-month open enrollment period at age 65, which provides access to the better rates that are offered to seniors.
- Annual rights to switch to another company: Each year around your policy's anniversary date, you have guaranteed issue protections to change to the same Medigap plan offered by another company. This lets you compare prices to find the best deal. If the plan isn't available, you can enroll in Plans A, B, D, G, K or L from any company in Missouri. This annual enrollment period starts 30 days before your policy anniversary and ends 30 days after.
- Disability: Those under 65 in Missouri who qualified for Medicare because of a disability have a guaranteed issue period during the six months after first signing up for Part B. However, rates are usually higher than what seniors pay.
- Medicaid: Medigap guaranteed issue is available for those who lose their Medicaid coverage.
- Disability: Those in Montana who qualified for Medicare because of a disability have a guaranteed issue period to enroll in Medigap during the 63 days after being informed that they're eligible for Medicare Parts A and B.
- Problems with getting care through Medicare Advantage: If your Medicare Advantage doesn't provide you with essential medical care in a timely way based on the plan's benefits, you qualify for guaranteed issue in Nebraska to switch to a Medigap plan.
- Switch to another Medigap plan on your birthday: If you already have Medigap, you have a two-month period annually where you can switch to another Medigap plan from any company, as long as the plan has the same or lesser benefits. The guaranteed issue period starts on the first day of your birthday month.
- Disability: Those in Nevada who qualified for Medicare because of a disability have a guaranteed issue period to enroll in Medigap during the six-month period after enrolling in Medicare Part B. There is a second open enrollment period in the six months after turning 65.
- Problems with getting care through Medicare Advantage: If your Medicare Advantage plan substantially fails to provide you with timely and medically necessary care based on the plan's benefits, you qualify for guaranteed issue in New Hampshire to switch to a Medigap plan.
- Disability: Those under 65 who qualified for Medicare because of a disability have a guaranteed issue period during the six months when they first become eligible for Medicare.
- Disability, under age 50: Those under 50 who qualified for Medicare because of a disability in New Jersey have guaranteed issue to enroll in a Medigap plan from Horizon Blue Cross Blue Shield of New Jersey during the six-month period after signing up for Medicare Part B. For most Medigap plans, costs will be higher than what seniors pay. However, Medigap Plan D must be offered at the same price as what someone age 65 would pay.
- Disability, age 50 to 64: Those aged 50 to 64 have guaranteed issue protections to enroll in a Medigap plan from any insurance company during the six-month period after signing up for Part B. The cost for plans must be the same as what a 65-year-old pays.
- Problems with getting care through Medicare Advantage: If your Medicare Advantage plan substantially fails to provide you with timely and medically necessary care based on the plan's benefits, you qualify for guaranteed issue in New Jersey to switch to a Medigap plan.
- There are no Medigap guaranteed issue protections in New Mexico beyond federal requirements.
- Continuous guaranteed issue: Insurers must accept a Medigap application at any time, regardless of health status, and insurers can't charge an enrollee a higher rate because of a health condition.
- Disability: Those under 65 who qualified for Medicare because of a disability have the same continuous guaranteed issue protections, and an individual Medigap application can't be denied. Plus, because New York uses a community-rated pricing model, there are no price differences by age, so those under 65 pay the same rates as seniors.
- Disability: Those under 65 who qualified for Medicare because of a disability have a guaranteed issue period for Medigap Plan A, D and G in the six months when they first become eligible for Medicare. Rates for those under 65 are typically higher than what seniors pay.
- Problems with getting care through Medicare Advantage: If your Medicare Advantage plan substantially fails to provide you with timely and medically necessary care based on the plan's benefits, you qualify for guaranteed issue in North Dakota to switch to a Medigap plan.
- There are no Medigap guaranteed issue protections in Ohio beyond federal requirements.
- Disability: Those under 65 who qualified for Medicare because of a disability have a six-month guaranteed issue period when they first become eligible for Medicare Part B, and there's a second protected enrollment period in the six months after turning age 65. Plus, each insurance company must offer at least Plan A to those under age 65, and there's a cap on costs. An enrollee under age 65 usually pays the same rate for a plan as a 65-year-old, though costs typically increase by age after 65.
- Switch to another Medigap plan on your birthday: If you already have Medigap, you have a 30-day window after each birthday when you can change to another Medigap company or plan if you select one that has the same or fewer benefits. But if you want a plan with better benefits, your enrollment wouldn't be protected and you'd go through the medical underwriting process. Note that for those who have high-deductible Medigap plans, a change in coverage means starting a new annual deductible.
- Disability: Those under 65 who qualified for Medicare because of a disability in Oregon have a guaranteed issue period in the six months when they first become eligible for Medicare.
- Disability: Those under 65 who qualified for Medicare because of a disability have a guaranteed issue period for all plans in the six months when first becoming eligible for Medicare.
- Annual guaranteed issue: For one month per year, insurers are required to offer Medigap Plan A with the protections of guaranteed issue. The insurance company chooses the month, so this is available at different times based on the insurance company.
- Disability: Those under 65 who qualified for Medicare because of a disability have a guaranteed issue period for Medigap Plan A in the six months when they first become eligible for Medicare. After this, enrollees can use the annual enrollment option to sign up for Plan A or change their insurance company.
- There are no Medigap guaranteed issue protections in South Carolina beyond federal requirements.
- Disability: Those under 65 who qualified for Medicare because of a disability in South Dakota have a guaranteed issue period in the six months when they first become eligible for Medicare.
- Disability: Insurance companies are required to offer at least one Medigap plan to Medicare enrollees who are under age 65, but there are no protections in the state's rules and regulations for those under age 65 about guaranteed issue of policies.
- Medicaid: Guaranteed issue is available if you lose Medicaid coverage.
- Disability: Those under 65 who qualified for Medicare because of a disability have a guaranteed issue period for Medigap Plan A in the six months after enrolling in Medicare Part B. Plus, when individuals turn 65, they'll have a second protected enrollment period for any Medigap plan.
- Medicaid: Those who lose Medicaid coverage because of a change in finances have guaranteed issue protections to buy a Medigap Plan A. If you're over 65, you'll also have guaranteed issue for Medigap Plans B, K and L. If you're over 65 and were first eligible for Medicare before 2020, you'll also have guaranteed issue protections for Medigap Plans C, F and high-deductible F.
- Medicaid: If you lose Medicaid coverage, you'll be protected with guaranteed issue to buy a Medigap plan within 63 days after losing coverage.
- Problems with getting care through Medicare Advantage: If your Medicare Advantage plan substantially fails to provide you with timely and medically necessary care based on the plan's benefits, you qualify for guaranteed issue in Vermont to switch to a Medigap plan.
- Disability: Those under 65 who qualified for Medicare because of a disability have a guaranteed issue period for all plan options during the six-month period after becoming eligible for Medicare. Plus, there's a second protected enrollment period at age 65.
- Disability: Those under 65 who qualified for Medicare because of a disability have a six-month Medigap guaranteed issue period after first becoming eligible for Medicare. Plus, there's a second protected enrollment period at age 65, when enrollees can usually get cheaper rates. However, this provision excludes those who are eligible for Medicare because of kidney failure (end-stage renal disease) or ALS, who only have one six-month guaranteed issue period at age 65.
- Switch Medigap plans at any time: If you already have a Medigap plan, you can switch your coverage at any time without going through medical underwriting. However, if you have Medigap Plan A, you can only switch to another Plan A. And if you have Medigap Plan B through N, you can only switch to another Medigap Plan B through N. In either case, there are no limits on which insurer you choose, allowing you to shop around for the best rates.
- Problems with getting care through Medicare Advantage: If your Medicare Advantage plan substantially fails to provide you with timely and medically necessary care based on the plan's benefits, you qualify for guaranteed issue to switch to a Medigap plan.
- There are no Medigap guaranteed issue protections in West Virginia beyond federal requirements.
- Disability: Those under 65 who qualified for Medicare because of a disability have two protected Medigap enrollment periods. The first six-month period happens when an enrollee first signs up for Medicare Part B, and the second enrollment period happens at age 65.
- Losing other coverage: Guaranteed issue is available for those who lose some or all of their coverage through an employer health insurance plan. You also have the ability to suspend a Medigap plan if you return to work and can get employer coverage, and you can reinstate the Medigap plan after the employer plan ends.
- Cost of employer coverage increases: You'll qualify for Medigap guaranteed issue if costs for your employer group coverage increase by more than 25% and the cost of the Medigap plan you're applying for is lower than the new rates.
- Problems with getting care through Medicare Advantage: If your Medicare Advantage plan fails to meet its contractual obligations, you qualify for guaranteed issue to switch to a Medigap plan.
- Medicaid: If you lose Medicaid coverage, you have guaranteed issue protections to buy any Medigap plan.
- Problems with getting care through Medicare Advantage or Medigap: If your plan substantially fails to provide you with timely and medically necessary care based on the plan's benefits, you qualify for Medigap guaranteed issue in Wyoming.
For those who are switching from Medicare Advantage to Medigap, a key issue when using your state's expanded enrollment protections is that the policies don't automatically allow you to drop your Medicare Advantage plan.
You can only disenroll from a Medicare Advantage plan during Medicare open enrollment (Oct. 15 to Dec. 7), during Medicare Advantage open enrollment (Jan. 1 to March 31) or if you qualify for a special enrollment period.
This can make changing your coverage a multistep process where first you change from Medicare Advantage to Original Medicare (Parts A and B) when the federal regulations permit it. Then you add on a Medigap plan when your state gives you Medigap guaranteed issue protections.
How to enroll in a Medigap plan
Without guaranteed issue
If you qualify for guaranteed issue
- Find a plan: Start by comparing your Medigap plan options on Medicare.gov or through an insurance company, agent, broker or plan comparison tool.
- Apply for coverage and complete a medical questionnaire: The insurer will usually ask you for details about your medical history. It could also request to access your medical records or prescription history.
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Your application is reviewed: Each insurer has its own medical underwriting guidelines, and Medigap applications may be automatically declined based on previous medical conditions such as uncontrolled diabetes or heart disease. The insurer will also use your medical information to determine how much you pay for coverage. For example, if you have issues like high cholesterol or high blood pressure, you could pay much more than another applicant.
- You decide if a plan is worth it: Plan costs will vary, and after you have a quote, you can compare the cost of the coverage to how much it will save you in medical expenses. For example, if you're quoted $400 per month after your medical questionnaire, you can compare that $4,800 annual investment to your expected medical savings to see if it's worth it.
Without guaranteed issue
- Find a plan: Start by comparing your Medigap plan options on Medicare.gov or through an insurance company, agent, broker or plan comparison tool.
- Apply for coverage and complete a medical questionnaire: The insurer will usually ask you for details about your medical history. It could also request to access your medical records or prescription history.
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Your application is reviewed: Each insurer has its own medical underwriting guidelines, and Medigap applications may be automatically declined based on previous medical conditions such as uncontrolled diabetes or heart disease. The insurer will also use your medical information to determine how much you pay for coverage. For example, if you have issues like high cholesterol or high blood pressure, you could pay much more than another applicant.
- You decide if a plan is worth it: Plan costs will vary, and after you have a quote, you can compare the cost of the coverage to how much it will save you in medical expenses. For example, if you're quoted $400 per month after your medical questionnaire, you can compare that $4,800 annual investment to your expected medical savings to see if it's worth it.
If you qualify for guaranteed issue
- Find a plan: You'll still start by comparing your Medigap plan options on Medicare.gov or through an insurance company, agent, broker or plan comparison tool.
- Apply for coverage: When completing your Medigap application, you'll specify the circumstances that make you eligible for guaranteed issue enrollment protections. This will mean you'll avoid answering any medical questions.
- Submit documentation: Depending on how you qualify for guaranteed issue, you may need to show documentation that proves your eligibility and shows when you became eligible. For example, this could be evidence of your new mailing address, postmarked letters that show your coverage is being terminated or emails about plan changes.
- Compare quotes: Even though your plan costs will not be based on any health information, Medigap rates can vary by insurance company, so comparing quotes for a few companies can help you to get the best deal.
What to know about changing your coverage
In general, it's easier to switch from Medigap to Medicare Advantage than the reverse. That's because Medicare Advantage has annual enrollment periods each year from Oct. 15 to Dec. 7 and from Jan. 1 to March 31.
During these enrollment periods, you can sign up for a Medicare Advantage plan or change plans without completing a medical questionnaire, risking coverage issues or paying more for coverage.
There are limited situations when the federal government provides the enrollment protections of guaranteed issue, which means you're guaranteed to be issued a policy if you want to switch between two Medicare Supplement plans or providers. Instead, most enrollees rely on state-level rules, which can vary.
Some states have made it very easy to change between two Medigap plans, allowing consumers to shop for coverage at least once per year. Other states have more specific situations when consumers can switch plans or have no expanded access beyond federal standards.
If you move when you have a standard Medigap plan (not a Select plan), your coverage will move with you.
You won't go through medical underwriting, and you can keep the same Medigap plan without any loss in health care access. That's because Medigap plans provide coverage for all doctors who accept Medicare, which is 99% of the country's providers. However, your costs for the Medigap plan will be adjusted to reflect the standard prices in your new state.
If you have a Medigap Select plan (which limits your health care to a network of providers) or have a Medigap plan in a state with nonstandardized plans (Massachusetts, Minnesota or Wisconsin), you will need to update your coverage after a move, and you'll usually qualify for guaranteed issue enrollment protections.
At the federal level, there isn't a protected Medigap enrollment opportunity for those who are under 65 and eligible for Medicare because of a disability or medical condition. Instead, open enrollment for Medigap occurs when an enrollee is at least age 65 and enrolled in Medicare Part B.
However, more than half of the states have additional provisions to make Medigap plans available to Medicare enrollees who are under 65. The scope of the rules varies by state: Insurance companies could be required to sell Medigap plans to those under age 65, there could be standard guaranteed issue periods, or there could be pricing restrictions to keep plans affordable.
For those under age 65, a Medigap plan is typically more expensive than what seniors pay. As a result, most Medigap enrollees who have disabilities will update their coverage at age 65 to access better rates. Alternatively, an enrollee may want to initially enroll in Medicare Advantage and switch to Medigap at age 65.
Your Medigap initial enrollment period is based on when you sign up for Medicare Part B. If you're still working at age 65 and have other coverage, you'll usually be able to defer enrollment in Medicare Part B without penalty.
As a result of deferring Part B, you'll also defer your initial Medigap enrollment period to give you the guaranteed issue protections after you retire and need new coverage.
Keep in mind that postponing Part B enrollment hinges on qualifying for a Medicare special enrollment period because you have both medical and prescription coverage from an employer or union that's at least as good as Medicare. Plus, the group insurance plan must have 20 or more employees. So if you have a smaller group plan or an individual plan, you won't qualify.
For those who are willing to take extreme measures, some insurance agents recommend moving outside of a Medicare Advantage plan's service area to automatically trigger a Medigap guaranteed issue period. This could be moving to the next county or to another state, depending on your current Medicare Advantage plan. Note that you can't just change your mailing address. You'll have to actually move in order to qualify.
Should you even switch to a Medicare Supplement plan?
When deciding between Medicare Advantage and Medigap, the two most important factors are usually access to your medical providers and the types of costs you'll pay.
Medigap plans are usually more expensive, but they'll also cover more of your health care expenses, making them a good deal if you need extensive medical care. Medigap plans also give you more provider flexibility because you can go to any doctor that accepts Medicare. This makes them a good choice for frequent travelers or those who have second homes.
In contrast, Medicare Advantage plans usually have low monthly costs and include perks like dental and fitness benefits. But the cost of medical care is based on your usage and can be as high as $7,550 per year. Plans also have a limited network of doctors and hospitals, and you'll pay more to go outside of the network.
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Frequently asked questions
Can you switch Medigap plans at any time?
Yes, you are allowed to change Medicare Supplement plans at any time. However, we don't recommend changing your Medigap coverage or enrolling in a new plan unless you have the protections of guaranteed issue. In these circumstances, you'll get the best rates, you can't be denied because of a preexisting condition and you will avoid medical underwriting.
Can you be denied a Medicare Supplement plan?
If you are in a Medigap enrollment period or have the protections of guaranteed issue, your application to enroll in a Medicare Supplement plan can't be denied. However, outside of these situations, you will have to go through medical underwriting when applying for Medigap, and your application may be denied because of a preexisting health condition, your age or other risk factors.
What's the difference between open enrollment and guaranteed issue?
These two terms are often used interchangeably because guaranteed issue protection (when you can't be denied coverage) happens during open enrollment (the window when you can sign up for plans). However, the protections of guaranteed issue can also occur outside of open enrollment, allowing you to enroll in a Medigap plan or switch your coverage if you meet the guaranteed issue criteria.
What are the states with the best Medigap guaranteed issue protections?
There are 12 states that provide guaranteed issue protections at least once per year to switch to Medigap or change Medigap plans: California, Connecticut, Idaho, Illinois, Maine, Massachusetts, Missouri, Nevada, New York, Oregon, Rhode Island and Washington.
Sources
Information about Medigap policies was gathered from Medicare.gov, the Centers for Medicare & Medicaid Services (CMS) and the following state insurance agencies:
- Nebraska
- Nevada
- New Hampshire
- New Jersey (and additional standards for those who have disabilities)
- New Mexico
- New York
- North Carolina
- North Dakota
- Ohio
- Oklahoma
- Oregon
- Pennsylvania
- Rhode Island
- South Carolina
- South Dakota
- Tennessee
- Texas
- Utah
- Vermont
- Virginia
- Washington
- Washington, D.C.
- West Virginia
- Wisconsin
- Wyoming
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Medicare supplement insurance is available to people age 65 or older enrolled in Medicare Parts A and B, and in some states to those under age 65 eligible for Medicare due to disability or end stage renal disease.
Medicare Advantage and Part D plans and benefits are offered by these carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Anthem Blue Cross, Aspire Health Plan, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, GlobalHealth, Health Care Service Corporation, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Baylor Scott & White Health Plan, Simply, UnitedHealthcare, Wellcare and WellPoint.
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