Medicare Supplement Open Enrollment Period
The Medicare Supplement Open Enrollment Period is a six-month window during which you can buy any Medicare Supplement plan you want.
During your Medicare Supplement Open Enrollment Period, insurance companies must issue you a Medicare Supplement policy, and are not allowed to ask you any health questions. Your OEP only occurs once, and if you miss it, you might have trouble getting supplemental health insurance coverage down the road.
When Can I buy a Medigap Plan?
- Buy a Medigap Policy When You’re First Eligible
It’s 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.
The six-month Medicare Supplement Open Enrollment Period starts the first day of the month they meet these criteria:
- They reached their 65th birthday
- Enrolled in Medicare Part B
During the Medigap Open Enrollment Period, Medicare beneficiaries can apply for Medicare Supplement insurance plans available in their state. (Plans C, F, and high deductible Plan F are only offered to seniors who become eligible for the federal Medicare program before Jan. 1, 2020.) Applying for a Medigap policy during open enrollment guarantees coverage without going through medical underwriting.
Guaranteed issue rights prohibit the insurance companies selling Medigap plans from doing certain things:
- Asking you questions about your health status
- Charging a higher premium because of health problems or pre-existing conditions
- Denying your application entirely
Some states have birthday rules and other special situations that allow Medicare beneficiaries to enroll in a Medigap plan without undergoing medical underwriting. Our licensed insurance agents can help you with any special rules that might apply in your state.
Because there are only a 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. Our licensed insurance agents can assist you in finding the plan that fits your current and future needs.
The Medicare Supplement Open Enrollment Period differs from the open enrollment period (also called the Annual Election Period) in the fall. The Annual Election Period applies only to Medicare Advantage plans and Medicare Part D prescription drug plans.
During your Medigap Open Enrollment Period
Medigap open enrollment is the only time insurance companies cannot require medical underwriting. Insurance companies must provide coverage, including for pre-existing conditions.
I’m 65 or older
Your Medicare Supplement Open Enrollment Period starts the month your Medicare Part B becomes effective. After that, you have six months to buy a Medigap plan. After six months, the insurance carrier can require you to answer health questions.
I’m turning 65
You can apply for Medicare up to three months before your 65th birthday. Once you receive your Medicare card, you can apply for a Medigap 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.
I’m under 65
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 some other disability. The first time is 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.
But you might not have access to Medicare Supplement insurance. Under federal law, insurance companies do not have to sell Medigap plans to individuals under 65. However, some states require carriers to sell Medigap plans to those younger than 65. In the states where Medigap plans are available, plan options are frequently limited to Plan A. Plans for individuals under 65 typically have higher premiums than those over 65.
I 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 can 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, but you have fewer protections. In a few situations, guaranteed issue rights do not apply, and you risk the insurance carrier rejecting your application.
Some states offer a different type of Medigap plan called Medicare SELECT. SELECT plans use provider networks and typically have lower premiums. If you buy a SELECT policy and decide to cancel within 12 months, you can switch to a regular Medigap plan.
I have a pre-existing condition
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.
I have other health insurance
You can wait to buy a Medigap plan if you have group health insurance coverage through an employer or union. When your group coverage ends, you have an open enrollment period to buy a Medigap policy. Your open enrollment period starts when you sign up for Medicare Part B.
I have a guaranteed issue right
Seniors who buy a Medigap plan under a qualified guaranteed issue right do not have to undergo a medical underwriting. The insurance carrier must sell you a policy, cover any pre-existing conditions, and cannot charge you a higher monthly premium due to pre-existing conditions.
Here are a few situations where guaranteed issue applies:
- You have Medicare Advantage or Medicare SELECT, and you move out of the plan’s service area.
- You lose your Medigap coverage through no fault of your own.
- You drop a policy or leave a plan because the insurance carrier misled you or didn’t follow the rules.