SPECIALIZING IN MEDIGAP MEDICARE ADVANTAGE, & PRESCRIPTION DRUG PLANS
Medicare Supplement Open Enrollment is a one-time window during which you can enroll in any Medicare Supplement policy. You will not have to answer any medical questions. The Medicare Supplement insurance companies cannot turn you down during your personal Medigap open enrollment period.
However, this period last for only 6 months, so be sure not to miss it unless you have other creditable coverage. Missing this Medigap open enrollment period (OEP) can have lifelong consequences in the form of higher premiums and limited coverage options.
It is important to know, your Medicare Supplement Open Enrollment Period is not the same as the open enrollment period that happens each fall, which is a common source of confusion. Open Enrollment dates for Medicare supplements vary for each person. Read on for details.
Unfortunately, federal law does not require Medigap insurance carriers to you except in certain situations. These policies are optional supplemental coverage so carriers can accept or decline you once your one-time OEP ends.
So if you don’t take advantage of your Medigap open enrollment window, you could find later on that you can’t medically qualify for a policy.
For this reason, it is often your best be to enroll during your personal Medigap OEP.
Your personal Medicare Supplement Open Enrollment period begins on the first day that your Part B becomes effective. If your Medicare Part A and Part B coverage start on June 1st, then your personal enrollment period lasts for exactly 6 months and ends on November 30th.
For most people this occurs at age 65 when they age into Medicare. However, some people delay enrollment into Part B while they are still working. Later when they retire and enroll in Part B, they will activate their Medicare Supplement Open Enrollment.
Some people qualify for Medicare early due to disability. These people will get an initial six-month open enrollment period starting with the Part B effective date. Later when they turn 65, they will get a second 6-month window.
This is because in many states people under age 65 do not have access to all Medicare supplements. For example, in Texas, the law only requires carriers to offer Medigap Plan A to people under 65. The law allows them a second chance at 65 when they can be assured to have access to more comprehensive Medicare Supplement plans like Plan F and Plan G.
Also, we should mention that if you have applied for Medicare early and you already know your Medicare claim number, you can submit your Medigap application well in advance of your Part B effective date.
The insurance company will still treat it as your Medigap open enrollment and process it with no health questions asked. We often have clients who lock in their Medigap plan several months in advance of their birthday month. There’s no need to wait until you turn 65.
Once you have applied for Medicare and receive your Medicare ID card in the mail, you can contact us to sign up for your Medigap plan. It can go into effect on the same day that your Medicare Part B starts.
You can apply for a Medigap plan (Medicare supplement) at any time of year. However, in most states, you must answer health questions on your application and go though medical underwriting. The underwriter can decline you for health reasons unless you are protected by your one-time open enrollment window or a guaranteed issue circumstance.
Some states an annual open enrollment for Medicare supplements. This enrollment window usually lasts for 30 days each year. It’s a great time to shop around for a supplement and see if any other insurance company offers the same plan for less.
To qualify for these you must already be on a Medicare supplement and be applying for a change to an equal or lesser benefit plan.
The timing of your Medigap enrollment greatly affects your available options and your ability to get coverage. Let me explain why.
The Medicare Supplement Open Enrollment Period is the only period you will ever have during which you can enroll in ANY Medicare supplement plan. If you enroll during this period, you can choose any Medicare Supplement plan – A, B, C, D, F, G, K, L, M or N.
Applications for Medicare supplements generally have a whole page of medical questions for you to answer. However, when you enroll within your 6-month window, you can skip all the health questions on the application. It doesn’t matter if you are healthy or sickly. The insurance company must accept your application and issue you the coverage when you apply during your Medicare Supplement Open Enrollment.
Once your Medicare Supplement Open Enrollment window ends, the insurance company can then require you to answer health questions on an application. They can accept or deny your coverage based on your health. Some people may have health conditions which will prevent them from getting coverage later.
That’s why the Medicare Supplement Open Enrollment period is important for many people.
Thousands of Medicare beneficiaries every year mistakenly believe they can apply for a Medicare supplement plan without health questions during the Fall Annual Election Period. This is incorrect, and comes as a rude awakening for people who didn’t do their research ahead of time.
The Open Enrollment period in the fall only applies to Part D drug plans and Medicare Advantage plans. Around here, we call it the Annual Election Period (AEP) instead, to help our clients differentiate between the two very different periods.
The AEP runs from October 15th – December 7th every year. During this time, people can join or leave their Part D drug plan. They can switch from one plan to another. They can do the same with Medicare Advantage plans. The AEP is a time when you can get into or get out of a Medicare Advantage plan.
The AEP does NOT give you a free pass into a Medicare supplement without having to answer health questions. As we stated earlier, you can apply for a new Medicare Supplement plan any time of year, but in most states you must answer health questions and pass medical underwriting to be approved.
Recently we spoke with a man who attended one of our New-to-Medicare webinars. He was unaware of the Medicare Supplement Open Enrollment period and therefore missed his opportunity. Due to some serious health conditions, no Medicare Supplement company would now accept him.
Fortunately, he will another option: Medicare Advantage. Medicare Advantage plans have only one health question which most people can pass. So during the next AEP, he can join a Medicare Advantage plan in his area.
He greatly would have preferred a Medicare Supplement since they allow you to see any doctor on Medicare. Medicare Advantage plans will require him to use their network of doctors in order to get the best copays.
However, I told him about Medicare Advantage PPO plans where he can still access doctors outside the Medicare Advantage network at a higher cost to him. This will at least offer him coverage instead of going with just Original Medicare only and having to pay 20% of things like surgery.
There are a couple of situations where an individual may be given two Medigap open enrollment periods.
The first is if you had Medicare prior to age 65 due to a disability. People who qualify for Medicare early will get a 6-month open enrollment window that starts with their Part B effective date while they are under 65. Later on when they turn 65 and age into Medicare naturally, they qualify for a second open enrollment period for Medigap. This starts with their 65th birthday and lasts for 6 months.
The reasons people in this situation are given a second open enrollment window is that in some states Medigap carriers are not required to offer all Medigap plans to people under 65. Therefore they must have a second chance to get a Medigap policy with no health questions asked once they turn 65 and have the same opportunity to enroll in any plan they want as their peers who didn’t get Medicare until age 65.
The second situation is if you enroll in Medicare at 65 and later return to a full-time job where you are offered group health coverage. You can drop your Medigap plan and your Part B since you have employer health coverage again. Later on when you retire again, you will sign up for Part B again and this will initiate a new 6-month open enrollment window.
Many people miss their Medigap open enrollment window because they are still working. Some of these people may have enrolled in BOTH Part A and B at age 65 to coordinate with their group health insurance and reduce their medical spending,. When they are ready retire a few years later, their Medicare Supplement Open Enrollment window has long passed.
Fortunately, Medicare has a guaranteed issue law in place for these people. As long as they maintained creditable employer group health coverage, they will be given a 63-day guaranteed issue window. During their GI period, they can enroll in Medigap plan A, B, C, F, K or L with no health questions. They do not need to worry about pre-existing conditions.
Note that Medigap Plan G is not one of the plans offered under Guaranteed issue rules. Plan G is a popular plan, so if you really want Plan G, you’ll need to apply for it and go through underwriting.
Worried about Medicare deadlines? We can help.
While the Medicare Supplement Open Enrollment Period 2019 may be the best time to get a policy, you can still apply for Medigap later on. Our team is happy to walk through the health question and help you see if you can qualify to apply for a Medicare supplement.