What to know about Medigap eligibility:
Who Qualifies for Medigap
- Medigap eligibility requires you to be enrolled in Medicare Parts A & B and be over 65.
- You can buy a policy outside of your Medigap open enrollment period, but your health history could affect your eligibility and premium.
- You cannot buy a Medigap policy if you have a Medicare Advantage Plan.
- If you’re under 65 and enrolled in Medicare, you may be able to buy a policy if you’re disabled.
To be eligible for Medicare Supplement insurance, you must be:
- Enrolled in Medicare Parts A & B (Original Medicare health insurance)
- 65 or older, or have a disability
One of the Medigap requirements is that you must not have a Medicare Advantage Plan. These two types of coverage are incompatible to have together. If you want to switch from a Medicare Advantage Plan to a Medicare Supplement policy, you must first disenroll from the Medicare Advantage policy.
You can learn more by reviewing the Medicare and You handbook.
Medigap eligibility and pre-existing conditions
Your Medigap eligibility to purchase a Medigap policy first begins when you are at least age 65 and are receiving Medicare Part B benefits. The first six months that you meet the Medigap eligibility requirements are called your Medigap open enrollment period, during which you have guaranteed issue rights. These rights allow you to purchase any of the 10 types of Medigap plans that are available in your area, without any regard to preexisting health conditions.
No matter what, it's always best to apply for a policy during the open enrollment period. That's because, during this period, insurers are not allowed to deny you a policy or raise your rates because of past health problems.
If you buy outside of the open enrollment period, this protection may not be there. In this situation, insurers may raise your rates or choose to not offer you a policy because of your past health problems. For more details, read our page on buying a Medicare Supplement policy.
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