Can I Get a Medicare Supplement Plan Anytime?

The first and biggest requirement when purchasing a Medicare Supplement plan (Medigap policy) is enrolling in Original Medicare (Part A and Part B). Beyond that requirement, eligibility for Medicare Supplement Insurance is tied to your age, state regulations, and timely enrollment.

Eligibility for Beneficiaries Turning 65

When turning 65, the best time to sign up is during the Medicare Open Enrollment Period. This period begins the first day of the month that you turn 65, and lasts for six months, as long as you have Medicare Part B. During this time, you can sign up for a Medicare Supplement policy without medical underwriting, and pre-existing conditions will not impact your plan options or premium rate.

Eligibility for Beneficiaries Under 65

Federal law does not protect Medicare beneficiaries younger than 65 who want to enroll in Medigap. However, some states require private insurance companies that sell Medicare Supplement Insurance to offer at least one plan with no medical underwriting to beneficiaries under 65 who are disabled or have end-stage renal disease (ESRD). Every state runs a State Health Insurance Assistance Program (SHIP), which offers free local counseling to Medicare beneficiaries. Contact your local agency or one of our licensed insurance agents to find out the health coverage regulations in your state.

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Can I Enroll at Any Other Times?

The only time you can sign up outside of the Open Enrollment Period is if you have guaranteed issue rights.

You may have a guaranteed issue right if you:

  • Are a member of a Medicare Advantage plan leaving the federal Medicare program or no longer servicing your area.
  • Have moved out of your Medicare Advantage plan service area.
  • Are a Medicare beneficiary with an employer or union health insurance plan that is terminating.
  • Joined a Medicare Advantage plan last year for the first time and now want to switch back to a Medigap policy.

Four states have guaranteed issue rights for beneficiaries 65 and older. If you are 65 or older, you can enroll outside of the Open Enrollment period without being subject to medical underwriting.

The four states are:

  • Connecticut
  • Maine
  • Massachusetts
  • New York

Pre-existing Conditions

The insurance company can impose a six-month waiting period if you buy a Medicare Supplement plan outside of your open enrollment period and have a pre-existing condition. The carrier will cover other health conditions but can refuse to cover out-of-pocket costs relating to the pre-existing condition. After the pre-existing condition waiting period ends, the insurance carrier will cover those costs.

When Is the Best Time to Enroll in a Medigap Policy?

If you do not have guaranteed issue rights, the overall best time to enroll in Medicare Supplement Insurance plans is during the Medigap Open Enrollment Period. Without guaranteed issue rights, a Medigap insurance company can decline applications received outside the Medicare Supplement Open Enrollment Period. If an insurer accepts your application, the insurance policy may come with exclusions for preexisting health problems if the health conditions were treated or diagnosed within six months of the policy start date. If you are subject to a waiting period for pre-existing conditions, you can still get Medicare coverage under Original Medicare for covered services. However, you are responsible for all the out-of-pocket health care costs, which Medigap would have otherwise covered.

Ready to Learn More?

Choosing the right Medicare Plan is not a decision that should be taken lightly. With Policy Guide’s assistance, you will have access to the knowledge and expertise of professional agents who can help you compare different health plans, quotes, and policies to ensure that you make an informed decision. Let us guide you through this process so that your chosen plan best suits your needs.

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Mark Prip

Since 2003, Mark Prip has been leading  Policy Guide, Inc., providing knowledgeable information about Medicare, life insurance, and dental coverage to clients in over forty states. With his unparalleled hands-on experience aiding countless Medicare beneficiaries in selecting an appropriate health plan, he is a prime example amongst other competitors for expertise and assistance. Mark has held his Florida Health & Life Insurance License (E051889) since 2003. View his license profile on the Florida Department of Insurance website.