Medigap Open Enrollment

2014 Medicare and Medigap Updates

One of the most common questions asked regarding Medicare supplement plans or Medigap plans, as they are more commonly known, has to do with the best time to purchase such a plan. Simply put, the best time to buy your Medigap plan is during the Medigap open enrollment period. The Medigap open enrollment period is a 6 month period which begins on the first day of the month that you choose to enroll in Medicare Part B. It should be noted that this enrollment period begins on condition that you are 65 years or older once you choose to enroll in Medicare Part B. Furthermore, once you enroll in Part B, the enrollment period begins and this cannot be changed.

There are a few important points to note about the Medigap open enrollment period. During this period, insurance companies cannot use medical underwriting. This means that insurance companies are restricted from charging you more for Medigap policies that they offer because of any past/pre-existing health conditions that you may have. Moreover, during the enrollment period, insurance companies cannot force you to wait for your coverage to start. Neither can they refuse to offer any Medigap policies that they are selling.

Individuals need to understand the importance of the Medigap open enrollment period as well as the consequences of failing to act before the period ends. As stated above, during the enrollment period, insurance companies are restricted from using medical underwriting. If you choose to apply for a Medicare supplement plan after the enrollment period has expired, the insurance company in question will probably use medical underwriting to determine the price of the policy. In most cases, the company will also use medical underwriting to approve coverage.

It is worth noting that even if your coverage is approved, the choices provided will be very limited. However, there are certain situations where you may still have the right to purchase a Medicare supplement plan after the Medigap open enrollment period has expired. During such situations, the policy has guaranteed issue rights also known as “Medigap protections”.

Guaranteed issue rights apply to situations where your health coverage plan is changing in some way. For instance, if you have union coverage that pays after Medicare pays and this coverage is ending, you have guaranteed issue rights. Another similar situation applies when one has a Medicare SELECT policy and they happen to be moving out of the plan’s service area. In these and more situations, insurance companies must sell to you a Medigap policy that covers all your pre-existing conditions. It is worth noting that the plans offered during such situations may be limited.

In order to have continuous coverage, it is advisable that one applies for their Medigap policy early, or at least some time when the Medigap open enrolment is in effect. One should not wait until their health coverage has expired to apply for their appropriate Medigap plan.