Medicare Supplement insurance plans or Medigap is an insurance plan offered by private health insurance companies that help beneficiaries pay their out-of-pocket costs of Medicare Part A and Part B plan. Though Medicare beneficiaries may apply for Medigap plans at any time of the year, but they may be charged more or can even be denied coverage outside the Medigap open enrollment period.
Medigap Open Enrollment Period for Individuals of Age 65 or Older
Medigap open enrollment period begins for individuals age 65 or older when they have both Medicare Part A and Part B coverage. The enrollment period for the Medigap plan for individuals age 65 or older is of six months’ period after they get enrolled in the Medicare Part B plan. The open enrollment period lasts six months and starts the first day of the month in which individuals turn 65 or older and they enroll in the Medicare Part B plan.
When Should Individuals of Age 65 and Older apply for Medigap Plans
Individuals can submit the Medigap application before the start of their Medicare Part A and Part B plans but they will require a Medicare number to enroll in the Medigap plans. The retired seniors can even apply for Medigap plan on the receipt of the Medicare card, one to three months before their 65th birthday month. This will give them time for the application to be processed and to start the Medigap plan in the same month in which their Medicare plan will become effective.
Importance of Open Enrollment Period
Individuals should apply for Medigap plans during the six months’ open enrollment period, Medigap plan provider cannot deny coverage to individuals based on their health issues or make them wait for the Medigap coverage because of their health or charge a higher premium for a Medigap plan because of their health. Health insurance companies offering Medigap plans cannot use medical underwriting during this period. Medical underwriting considers an individual’s health conditions and the costs to provide the coverage and may even reject them based on health problems. During the open enrollment period, individuals can have any health problems, and still, they can be issued a Medigap plan. If they apply for the Medigap plan after the open enrollment period, then there are chances that the plan may reject them or charged them more based on their health condition.
Enrollment in Medigap Plans for People under 65 years of Age
Health insurance companies according to Federal laws are not required to sell Medigap plans to people below the age of 65 years and so generally there are no open enrollment periods for Medicare beneficiaries under 65 years of age. Thus, Medicare beneficiaries of under 65 years of age if wish to obtain Medigap plans can apply for these plan at any time. However, individuals under 65 are eligible for Medicare only if they have a disability or serious health condition. Medigap insurers are based on that disability or health condition and the cost to insure such individuals may reject their application. Some of the states do have an open enrollment period for eligible individuals under 65 years of age and these individuals can check with their state health insurance department for guidelines.
Options to Enroll in Medigap Plans Outside the Open Enrollment Period
Individuals on being the outside Medigap open enrollment period may apply for another Medigap plan if they have guaranteed issue rights. A guaranteed issue right means that a health plan cannot deny coverage to an individual or refuse to cover his/her pre-existing conditions or make him/her wait for the coverage. Individuals can qualify for guaranteed issue rights on the following conditions:
- If their Medigap plans committed fraud or mislead them
- If the Medigap plan went bankrupt
- If the individual dropped their Medigap plan to make use of their trial right to try a Medicare Advantage plan and in less than a year time wants to switch back to the Medigap plan.
- If their Medicare Advantage Plan is no more offering care in their area
- If the individuals have moved out of their Medicare Advantage plan’s service area.