When may I enroll in a Medicare Supplement (Medigap)?

You may enroll in a Medicare Supplement at any time. There are no constraints when you may join, switch or drop Medicare Supplement (Medigap) plan. It is important to note that the Medicare Supplement enrollment normally includes a medical evaluation, and the insurance company may reject your application based on poor health, so you should consider the preferred enrollment periods described below.

Medicare Supplement Open Enrollment Period

Medicare Supplement Guaranteed Issue Rights

Switching Medigap Plans

Variations in Medicare Supplement Underwriting

Medicare Supplement Open Enrollment Period

The best time to enroll in a Medigap plan is during the Medigap Open Enrollment Period – a six month period after you’ve enrolled in Medicare Part B. During this period an insurance company cannot use medical underwriting:

  • They cannot refuse to sell you a Medigap policy
  • They cannot charge you more due to existing health problems
  • They cannot make you wait for coverage to start, as long as you have at least six months of prior creditable coverage when you first enroll in a Medigap and have had this prior coverage within the last 63 days

If you apply for a Medigap policy after your Open Enrollment Period, the insurance company is allowed to use medical underwriting to decide whether to accept your application, to charge more for the policy, or to impose its regular (up to six months) pre-existing conditions waiting period.

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Medicare Supplement Guaranteed Issue Rights

Under certain circumstances you are entitled to Guaranteed Issue Rights. If you are entitled to Guaranteed Issue Rights, the insurance company:

  • Cannot refuse to sell you a Medigap policy
  • Cannot charge you more due to existing health problems
  • Cannot make you wait for coverage to start (including a waiting period for coverage of pre-existing conditions)

In other words, you are guaranteed to qualify to buy a Medigap policy without medical underwriting, i.e. without having to answer any health questions.

In order to be entitled to Guaranteed Issuance, there must be a trigger event, such as:

  • Loss of health insurance (such as group coverage) through no fault of your own
  • Moving out of a Medigap SELECT plan area
  • Supplemental carrier discontinues offering coverage
  • Your Medicare Advantage plan leaves Medicare, or you move out of a Service Area
  • You enrolled in a Medicare Advantage plan when you were first eligible for Medicare (the first 12 months of enrollment), and now you want to switch back to Original Medicare
  • You dropped Medicare Supplement plan for a Medical Advantage plan (the first 12 months of enrollment), and now you want to switch back

Notice that moving from one state to another is not considered to be a trigger event. Depending whether the insurance company is represented in your new state, you can either continue to pay premiums within the state where the policy was issued, or the policy will be issued by the same company in the new state.

You have a limited time to purchase the Medigap policy, known as Guaranteed Issue Period.  It is normally 63 days from the triggering event. You are allowed to purchase ONLY the following Medicare Supplement plans: Medigap Plans A, B, C, F, K and L. For more details, see Compare Medicare Supplement Plans.

In addition to Guaranteed Issues described above, some states have Special Guaranteed Issue Periods. For example:

  • In Connecticut everyone has guaranteed issue at all times
  • In Missouri there is a 30-day guaranteed issue window on the anniversary of your current Medigap policy
  • In California there is a 30-day guaranteed issue window that begins on your birthday

Check the regulations in your state for more information.

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Switching Medigap Plans

There may be many reasons why you want to switch the Medicare Supplement plan. Some of these include:

  • Having unnecessary benefits
  • In need of more benefits than you have now
  • You are unhappy with the insurance company
  • You’d like to have a less expensive policy

You may switch a Medigap policy at ANY time, as long as an insurance company is willing to sell it to you. Your insurance application will be subject to medical underwriting, and there is no obligation on the part of the insurance company to accept you.

How your new Medigap policy covers the pre-existing conditions depend on how long you already had the Medigap plan. There is no waiting period for pre-existing conditions as long as you had the Medigap plan for 6 months or longer.

Overall, Medigap switching options are quite limited. Therefore, make a right selection at Medigap Open Enrollment Period.

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Variations in Medicare Supplement Underwriting

Even though Medicare Supplement Underwriting Guidelines are similar in most respects, there are a few essential differences. For example:

  • Some companies will refuse coverage for anyone who has had a heart attack, stroke of any kind or congestive heart failure within the past five years. Other companies reduce this period to three, or even to two years.
  • Most companies will refuse coverage to anyone who has been hospitalized in the past two years two or more times, or has been advised to undergo surgery (but has not yet done so) in the past two years. Some companies reduce this period to one year.
  • Some companies will refuse coverage for anyone with insulin dependent diabetes, others will refuse coverage only if the number of daily units of insulin exceeds a critical value, such as 50 or 70 units.

These rules can make the difference between an application being accepted or rejected by an insurance carrier. Check with Liberty Medicare insurance agent prior to applying.

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Let us Help you to Enroll in a Medicare Supplement

If you are looking for Medicare Supplement coverage, Liberty Medicare is here to assist you. We’ll help in all stages of comparing, selecting and enrolling in the best and most suitable Medicare Supplement Plan for you. Our services are offered at no cost to you.

Learn more about all benefits of working with Liberty Medicare.

Give us a call at 877-657-7477, or Contact us with your Medicare Questions.