Can I change Medigap plans after my Open Enrollment Period?
Under federal law, you have a guaranteed issue right to buy a Medicare Supplement insurance plan (also known as MedSupp or Medigap) during the Medigap Open Enrollment Period, which begins the first month you have Medicare Part B and are age 65 or older. This means that during this six-month enrollment period, insurers cannot turn you down or charge you more because of a pre-existing health condition.
After the Medigap Open Enrollment Period, insurers can refuse to sell you a Medigap policy, delay coverage, or charge you a higher premium because of an existing health condition. The insurance company may also ask you to submit to a medical underwriting process and deny you coverage or charge you a higher rate based on its findings.
There are some exceptions to the rule, however. In some situations, you have the guaranteed-issue right to buy a Medicare Supplement policy outside of your Medicare Supplement Open Enrollment Period:
- You have a Medicare Advantage plan, and the insurance company has left your service area.
- Your Medicare Advantage plan has been discontinued or is leaving Medicare.
- You have moved out of your Medicare Advantage plan’s service area.
- You currently have Original Medicare, and your employer coverage is ending.
- You have Original Medicare coverage and a Medicare SELECT plan, and you move out of the Medicare SELECT plan’s service area.
- You lose your Medicare Supplement insurance plan because the insurance company went bankrupt.
- You end your Medigap coverage because the insurance company misled you or was not compliant with the law.
You may qualify for guaranteed issue into a Medicare Supplement insurance plan, regardless of your medical history, if you meet certain criteria such as applying during your Medicare Supplement Open Enrollment Period. Additional guaranteed issues rights may be available and are dependent on your state of residence.
There are additional reasons that may qualify you for a “trial right” to purchase a Medigap policy. For this reason, you should shop around and check with the individual insurance company in your state to see if changing Medicare Supplement insurance plans is possible in your situation.
Will I have to wait for coverage after changing Medigap plans?
After changing Medigap plans, you may have to wait to receive coverage for certain benefits. If this is outside the Medigap Open Enrollment Period and you have a pre-existing condition* (assuming the insurer lets you make the switch), you may have to wait to be covered for expenses associated with that condition. The wait time for coverage of your pre-existing coverage can be up to six months.
Also, if after changing Medigap plans, the new plan offers benefits that aren’t covered under your current plan, you may have to wait up to six months to be covered for those new benefits as well.
Do I have to change Medigap plans if my older policy has been discontinued?
You do not have to change plans just because your Medigap policy is no longer offered. Older Medigap policies have different coverage than plans being currently sold. For example, Medigap policies sold after January 1, 2006, no longer include prescription drug coverage, but if you purchased your plan before then, you can keep the older policy. You may want to hang on to your older Medigap policy if it includes coverage for prescription drug expenses, and changing Medigap plans would dramatically increase your out-of-pocket costs for prescription drugs.
At the same time, keep in mind that newer, current Medicare Supplement insurance plans may have additional advantages not included in your older plan, such as guaranteed renewable policy or a lower premium. It is important to weigh your present health needs and compare plans to find the best fit for you.
If you decide to cancel your older policy (outside of the 30-day “free look” period), you cannot get it back since it is no longer available as a standardized Medigap plan.
Can I change my mind about switching Medicare Supplement insurance plans?
If you decide to change Medigap plans, you can still keep your old plan for up to 30 days before canceling it. You must promise to cancel the old Medigap plan when filling out the application for the new plan, but you’re allowed a 30-day “free-look” period, in case you opt against changing Medicare Supplement insurance plans. This period begins when you start your new policy. You should not cancel your old plan until you are sure that you want to keep the new policy.
Be aware that you’re required to pay both premiums during the 30-day “free-look” period.
Do you have more questions? Connect with me to answer your Medicare questions or discuss a Medicare plan option that may be right for you.
Still unsure if you need a Medicare Supplement Plan? Having a better understanding of what a plan entails will help! Read this next: What Are Medicare Supplement Plans?
By David Lasman – “Ask Medicare Dave” | President – Senior Healthcare Team
wwww.SeniorHealthcareTeam.com | 866-333-7340
Selecting the right healthcare plan through Medicare can be overwhelming and downright stressful. Senior Healthcare Team is a nationwide resource that provides guidance and support about Medicare to seniors at no cost to them and helps them to choose the most suitable insurance plan tailored to their specific needs and budget. Our goal is to educate and empower our clients to make the best decisions regarding their healthcare and clear up the confusion of Medicare. At Senior Healthcare Team, we aren’t partial to any one insurance company. Our loyalty is to our clients and our mission is to provide them with the best healthcare options at the very lowest cost.