Medigap Enrollment Period

2014 Medicare and Medigap Updates

Medigap Enrollment Period Rules

One of the most important things to understand should one consider buying a Medigap policy is the Medigap enrollment period. Simply put, the Medigap enrollment period is the most opportune time to purchase a Medigap insurance policy because it is during this period that all Medigap-offering insurance companies are required by law to approve all Medigap applications without consideration for pre-existing conditions. In simple terms, that means you are entitled to any of your chosen Medigap plans at this time and companies will be obliged to grant your policy application as is.

So when does the Medigap enrollment period take effect?

The Medigap enrollment period refers to a narrow period lasting six months that begins on the first day of the month when you turn 65 and concurrently enrolled in Medicare Part B. Upon enrollment in Medicare Part B, the next six months preceding the first day of the month of your birthday entitles you to enroll in any other Medigap policy without refusal, deferral or extra premium pricing as may be done by companies in other cases when individuals purchase insurance policies. Of course, you can always apply for a Medigap policy ahead of the enrollment period to ensure continuous coverage. However, during this advanced period, companies can argue to defer the start of your coverage to some later time due to certain medical reasons. Should this happen, it is recommended that you wait for the Medigap enrollment period to kick in prior to applying for a policy.

Should your application push through without any further inquiries, then you are guaranteed to avail of Medigap supplemental policies early on for any illness that is beyond the coverage of standard Medicare or as stipulated by the coverage in your purchased policy.

There are also cases when would be Medigap policy owners miss their Medigap enrollment period when purchasing their chosen Medigap policies. Be mindful if this happens companies can implement medical underwritings specific to your situation and you will have to pay higher premiums. Medical underwritings are a fancy term for premium price recalculations where companies can levy extra fees on your premium price because of medical conditions that are likely to cause you to visit the hospital or doctor on a more frequent basis. They know this will also raise the number of times you make claims on your supplemental Medigap policy.

Certain instances allow policy owners to invoke guaranteed issue rights or Medigap protections. Medigap protections work like the Medigap enrollment period in that insurance providers are mandated by law to grant your request for purchase of a specific plan should you satisfy certain preconditions. In the state of Louisiana, for example, there are six exempting conditions that entitle a customer to Medigap policies even beyond their Medigap enrollment period. A well-documented example is when “You are enrolled in a Medicare Advantage plan, HMO or Medicare Select and you move away from the service area.” A new 63-day waiting period which works like a Medigap enrollment period takes effect if “You return to Original Medicare and apply for a Medigap policy within 63 days. Your 63-day window begins the day your coverage ends.”

Take time to study the specific guaranteed issue rights in your state or better yet, make sure to not miss your Medigap enrollment period so you don’t have to argue your way into a Medigap policy. In the same way, remember that state law has defined ways for you to avail of your policies with as minimal or fair cost as possible. Study your options properly so you can get the best Medigap policy that works for you.

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