Medicare Supplement (Medigap) Open Enrollment Period

The Medicare Supplement Open Enrollment Period is a six-month window of time during which you may choose any Medicare Supplement (Medigap) plan.  

During your Medicare Supplement Open Enrollment Period, insurance companies must issue you a Medicare Supplement (Medigap) policy without asking any health questions. Your Open Enrollment Period only occurs once, and if you miss this window, you may have trouble getting supplemental health insurance coverage down the road.  Therefore, it is best to apply for a Medicare Supplement insurance policy when you are first eligible to protect against hefty out-of-pocket costs and ensure coverage.

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When Does My Medicare Supplement Open Enrollment Period Begin?

The six-month Medicare Supplement Open Enrollment Period begins on the first day of the month during which enrollees meet BOTH of these criteria:

• Have attained 65 years of age
• Have enrolled in Medicare Part B

During the Medigap Open Enrollment Period, Medicare beneficiaries may apply for Medicare Supplement insurance plans available in their state. Applying for a Medigap policy during open enrollment guarantees coverage without going through medical underwriting.  This assurance is known as “guaranteed issue rights”.

What Are Guaranteed Issue Rights?

Guaranteed issue rights prohibit insurance companies from doing any of the following:

• Asking you questions about your health status
• Charging a higher premium due to health problems or pre-existing conditions
• Denying your application entirely

Because there are so few situations where guaranteed issue rights apply, the Medicare Supplement plan you buy during this initial enrollment period is likely the plan you’ll have for the rest of your life, so working with an experienced agent is critical in order to take into account both current and possible future healthcare needs.

Other Medigap Open Enrollment Opportunities

If you are turning 65 in the near future:

You may apply for Medicare up to three months before your 65th birthday. Once you receive your Medicare card, you may apply for a Medigap (Medicare Supplement) policy.

Some insurance carriers allow you to apply for Medigap insurance up to six months before your Part B becomes effective. The company will treat your application as if you were already in your Medicare Supplement Open Enrollment Period and will not ask questions about your health conditions. However, you will not receive any benefits from your Medigap policy until you turn 65 and your Part B becomes effective.

If you are under 65 with a qualifying disability:

You have two open enrollment periods if you are under 65 and have Medicare coverage due to end-stage renal disease (ESRD), amyotrophic lateral sclerosis (ALS), or another qualifying disability. The first open enrollment period begins the month your Medicare becomes effective and continues for six months. Then, when you turn 65, you will have a second six-month open enrollment period that starts the first day of your birth month.

Important:  Each state sets its own rules to determine whether disabled Medicare beneficiaries under age 65 are guaranteed enrollment in supplemental coverage.  Medicare supplement coverage is not guaranteed in all states for this situation.  Please check with a licensed insurance agent for more information.

If you already have group health coverage through an employer or union:

Some Medicare beneficiaries over 65 have group health coverage through an employer or union because they (or their spouse) are still working. Those seniors might want to delay enrolling in Medicare Part B. Group health plans frequently provide benefits similar to Medicare Supplement insurance, so a Medigap policy is unnecessary. When you retire and your group coverage ends, you may enroll in Part B without a late penalty. Once your Part B becomes effective, you have six months to buy a Medigap plan. After that, the insurance carrier can require you to answer health questions.

Outside Medigap Open Enrollment Period

You can apply for Medigap insurance after your Medicare Supplement Open Enrollment Period ends (even with a preexisting medical condition), but the insurance carrier has the right to increase your premium or reject your application for coverage.

Note: Certain states have year-round open enrollment, so it is wise to work with a licensed insurance agent who can inform you of the status of open enrollment in your state.

FAQ's

• When Does Medigap Open Enrollment Take Place?

  The Medigap Open Enrollment Period starts when you turn 65 and enroll in Part B Medicare.

• How Long Is Open Enrollment for Medicare Supplement Policies?

  The Medigap Open Enrollment Period lasts six months. It begins when you are both 65 and enrolled in Medicare Part B.

• Can You Enroll in a Medicare Supplement Plan at Any Time?

  You can enroll in a Medicare Supplement plan anytime, but the insurance company is not required to provide coverage. The best time to get a Medicare Supplement policy is during the Medicare Supplement Open Enrollment Period because coverage is guaranteed, including coverage for pre-existing conditions.

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Article Resources

• Medicare Supplement Open Enrollment Period
• Guaranteed-Issue Rights