When Can I Change My Medicare Supplement Plan?
You can change our Medicare Supplement Insurance plan (Medigap) during your Medigap Open Enrollment Period or any other time of year, but you may want to follow some of these rules to avoid being denied coverage or charged higher premiums for pre-existing health problems.
Medicare – like most large, complicated systems – can be confusing. There are any number of issues with Medicare that can be hard to decipher. One of the most confusing involves when you can and cannot sign up for or change a Medicare Supplement plan, also known as Medigap.
The rules for enrolling in and changing Medicare Supplement Insurance plans are different than the rules for other parts of Medicare. Let us help you understand the differences.
What Is a Medicare Supplement (Medigap) Plan?
Original Medicare, which includes Part A and Part B, covers most but not all of your medical care. Some costs that aren’t covered, such as Medicare deductibles, copays, coinsurance and some other costs. Medigap plans are designed to fill those gaps by supplementing your Original Medicare coverage to pay for certain out-of-pocket costs.
A Medicare Supplement plan may pay your coinsurance or copayments from Medicare Part A and Part B. Some Medigap plans also cover Part A and/or Part B deductibles and other costs.
You can use the chart below to compare the out-of-pocket Medicare costs that different types of Medigap plans cover.
Scroll to the right to continue reading the chart
Medicare Supplement Benefits
Part A coinsurance and hospital coverage
Part B coinsurance or copayment
Part A hospice care coinsurance or copayment
First 3 pints of blood
Skilled nursing facility coinsurance
Part A deductible
Part B deductible
Part B excess charges
Foreign travel emergency
* Plan F and Plan C are not available to Medicare beneficiaries who became eligible for Medicare on or after January 1, 2020. If you became eligible for Medicare before 2020, you may still be able to enroll in Plan F or Plan C as long as they are available in your area.+ Read more
1 Plans F and G offer high-deductible plans that each have an annual deductible of $2,370 in 2021. Once the annual deductible is met, the plan pays 100% of covered services for the rest of the year. The high-deductible Plan F is not available to new beneficiaries who became eligible for Medicare on or after January 1, 2020.
2 Plan K has an out-of-pocket yearly limit of $6,220 in 2021. After you pay the out-of-pocket yearly limit and yearly Part B deductible, it pays 100% of covered services for the rest of the calendar year.
3 Plan L has an out-of-pocket yearly limit of $3,110 in 2021. After you pay the out-of-pocket yearly limit and yearly Part B deductible, it pays 100% of covered services for the rest of the calendar year.
4 Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to $50 copayment for emergency room visits that don’t result in an inpatient admission.- Read less
Original Medicare is offered by the government. Part A is usually free for most beneficiaries, and Part B carries a monthly premium. Medigap plans, however, are sold by private insurance companies. You must shop for these plans, and a licensed insurance agent can help you pick the one that offers you the best coverage at the best rates.
Medicare Supplement plans carry letters to designate the benefits each type of plan offers. Thus, every plan with the same lettered name has the same basic coverage almost anywhere in the country.
For example, Medicare Supplement Plan G sold by X Insurance Company will include the same benefits as a Supplement Plan G sold by Y Insurance Company in most states. The exceptions are Massachusetts, Minnesota and Wisconsin, which standardize their supplement plans differently.
When Can You Enroll in a Medigap Plan?
If you do consider enrolling in a Medigap plan Medigap plans, you should try to apply for a plan during your 6-month Medigap Open Enrollment Period. Your Medigap Open Enrollment Period is a 6-month period that starts the day you are both 65 years old and enrolled in Medicare Part B.
During your 6-month Medigap Open Enrollment Period, you do not have to undergo medical underwriting, which means the insurance company cannot turn you down or charge you higher premiums because of any pre-existing health condition.
If you don't change Medicare Supplement insurance plans during your Medigap Open Enrollment Period, your insurer can force you to undergo medical underwriting, and they can now assess your health history during the application process and can turn you down if it chooses.
When Can You Change Medigap plans?
Just as you can enroll at any time of the year (as long as you have Part B), you also can change Medicare Supplement plans at any time. But again, if it’s not during your Medigap Open Enrollment Period or if you don’t have a guaranteed issue right, you must pass the provider’s medical underwriting process to qualify in most states.
Some states – including California, Washington, Oregon, Missouri and some others – allow you to change Medicare Supplement plans without going through the underwriting process.
What Are Guaranteed-Issue Rights?
The main way to avoid medical underwriting is if you have a Medicare Supplement insurance guaranteed-issue right.
Some guaranteed-issue rights occur when:
- Your Medigap insurance company went bankrupt or ended your policy through no fault of your own.
- Your Medigap insurance company committed fraud and you are canceling your policy.
- You leave your current Medigap insurer because the company misled you.
- You signed up for a Medicare Advantage plan for the first time, but then choose to cancel that policy and return to Original Medicare with a Medicare Supplement insurance plan instead.
- You have a Medicare SELECT plan, and you move out of the service area. Medicare SELECT plans have restricted provider networks that you can choose from. If you leave the network area, you can switch to a standardized Medicare Supplement insurance plan with the same or fewer basic benefits as your SELECT plan, or you can purchase certain other Medicare Supplement plans.
- You’ve been enrolled in a Medicare Supplement insurance plan for fewer than six months. Your insurance company may agree to sell you a new policy with the same basic benefits, but you may have to wait up to six months before the new plan covers any pre-existing health conditions.
If any of the above situations apply to you, you can switch Medigap plans without medical underwriting. You must apply no later than 63 calendars days after the previous health coverage ends.
Please note that there are other situations when you may qualify for a guaranteed-issue right. Find out if you qualify for a guaranteed-issue right today.
If your Medigap Open Enrollment Period is over and you don't qualify for a guaranteed-issue right, you can still make changes, but it could cost you.
The Medicare Supplement “Free Look” Period
When you switch Medicare Supplement Insurance plans, you generally are allowed 30 days to decide to keep it or not. This 30-day “free look” period starts when your new Medicare Supplement plan takes effect. To qualify, you need to pay the premiums for both your new plan and your old plan for one month.
Should You Change Your Medigap Policy?
You may want to consider changing your plan or insurance company to increase your benefits or lower your monthly costs.
If you are happy with your current policy, there is no reason to change plans. But you may be interested in changing policies under certain circumstances:
- Better price
Every September, insurance companies must send out a Medicare Annual Notice of Change (ANOC) letter to Medicare beneficiaries. This letter tells you of any changes to your rates. If your rates go up, you may want to consider looking for a new policy. You can shop around for a similar plan offered by the same company or a different company for a lower premium.
- More coverage
If you decide you need more coverage, you can switch to a different plan letter to get more benefits.
- Less Coverage
Likewise, if you don’t need or want to keep paying for benefits you don’t use, you might consider switching to a more basic plan if it offers a lower premium.
- Different Provider
If you are unhappy with your insurance company for any reason, you can purchase a plan from a different insurance underwriter.
Call to speak with a licensed insurance agent who can help you compare Medicare Supplement plans in your area. They can help you change plans once you find the best plan for your needs. You can also compare plans online for free.
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