The federal government passed lots of rules for Medicare supplement plans. These plans pay secondary to Original Medicare, but when can you enroll in one or switch plans? To help you make sense of Medicare supplement plans, we’ll explain what a Medicare supplement is and the times you can enroll.
While your focus may be on deciding between which plan, including options like Medicare Plan G – Part G or Plan N, it’s important to understand the basics of Medicare Supplements and rules surrounding them as a whole first.
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What Are Medicare Supplement Plans?
A Medicare supplement plan, also called Medigap, helps to fill the gaps that Original Medicare doesn’t cover, such as copayments, coinsurance fees, and deductibles.
Medicare is a fairly comprehensive plan for those who enroll in Original Medicare, but it doesn’t cover everything and definitely not at 100%. With a Medigap plan, you’ll pay less in out-of-pocket expenses since Original Medicare only does not have a maximum out-of-pocket limit.
Health insurance companies in your state offer Medicare supplement plans. Medicare Supplement plans only pay secondary to Original Medicare.
Opportunities to Change Medicare Supplement Plans
You can change your Medicare supplement plan whenever you want. But, if you switch outside of your initial 6-month Medicare Supplement Open Enrollment Period, your rate may be based on your health and health history (health underwriting). Also, insurance companies may be able deny you coverage.
Six-Month Medigap Open Enrollment Period
The open enrollment period for Medicare supplement plans starts on the first day of the month when you turn 65 and are enrolled in Medicare Part B. Open enrollment lasts for six months.
During open enrollment, Medicare supplement companies cannot deny you coverage or charge you more based on your health history. This is also the time to get the best prices and choice of policies.
Trial Right
When you’re first eligible to enroll in Medicare and select a Medicare Advantage plan, you are given up to 12 months to try the plan out. During this time, you can switch back to Original Medicare.
The trial period also gives you the right to buy a Medigap plan with no health questions asked.
Guaranteed Issue Windows
There are some special circumstances where you can change or enroll in a Medigap without underwriting. Some examples include losing employer-sponsored retiree coverage, and in some states, losing Medicaid. You may also qualify for a Guaranteed Issue (GI) window if you have a Medicare Advantage plan and move outside your plan’s service area.
In certain states, you can switch to another Medicare supplement plan without having to answer health questions or go through underwriting thanks to certain state laws. You can’t be denied coverage, and insurance companies can’t charge you more because of your health. A few rules that some states have created are the Medigap Birthday Rule, Anniversary Rule, and Year-Round Open Enrollment.
For example, in states like New York and Connecticut, you can apply to a Medigap policy year-round without being denied.
In other states such as California, there is a birthday rule that allows those with existing Medigap policies to change plans around their birthday without having to answer health questions.
Not every state has these underwriting exceptions, and even if they do, remember that the specific rules can vary by state and insurance carrier.
Reasons to Consider Switching to a Medigap Plan
While Original Medicare and a Medigap plan may initially seem like a good choice, things don’t always work out. After some time with your current plan, you may find yourself looking for better coverage, lower monthly premiums, or a different insurance carrier due to customer service reasons. Changes to your health and financial situation tend to be the main reasons for a change.
Tips for Switching Your Medicare Supplement Plan
Anytime you make changes to your Medicare plan, it’s wise to do your research and get expert advice if you need it. The Centers for Medicare & Medicaid Services (CMS) offers guidance, and a Medicare broker or agent can answer your questions.
Here are some final tips if you’re considering changing your Medicare supplement plan:
- Consider the impact of switching plans
- Be aware that in most cases, you’ll have to answer health questions, and your rate could be higher
- Compare plans from different insurance carriers
- Don’t cancel your current plan before the new one takes effect
Also Read: How Insurance Lawyers Can Assist With Life Insurance Claims
Conclusion
The simple answer to whether you can switch Medicare supplement plans anytime is yes. That said, the choice you make could have unintended consequences if you move forward at the wrong time or without having all the facts.
For example, it’s important to understand the circumstances that give you a guaranteed issue right. The best time to get a Medigap plan is when you first enroll in Medicare Part B.
Depending on your reason for wanting to switch your Medicare supplement plan, it may be worthwhile to switch plans outside that initial open enrollment period. Just be wary that underwriting may be required.
In any case, evaluate your needs carefully and explore various options before making your final decision.