Can I Enroll in a Medicare Supplement Plan at Any Time?
Enrolling in Original Medicare (Part A and Part B) is the first and biggest requirement when purchasing a Medicare Supplement plan (Medigap policy).
Beyond that requirement, eligibility for Medicare Supplement insurance is tied to your age, state regulations, and timely enrollment.
Throughout this page, we’ll cover:
- Medigap eligibility (under and over 65)
- Alternatives to Medigap
- Special enrollment periods
- How to enroll (a step-by-step guide)
Let’s start by breaking down Medigap eligibility.
Medigap Eligibility for Beneficiaries Turning 65
For Medicare beneficiaries turning 65, choosing a Medicare Supplement (Medigap) plan is an important decision. These plans help cover out-of-pocket costs like deductibles, copayments, and coinsurance that Original Medicare doesn’t pay.
The best time to enroll in a Medigap plan is during your Medigap Open Enrollment Period (OEP), which begins the first month you are both 65 and enrolled in Medicare Part B.
This six-month window is crucial because:
- You can enroll in any Medigap plan available in your state without medical underwriting – meaning you have a guaranteed issue right and insurers can’t deny you coverage or charge you higher premiums due to health conditions.
- You have access to all Medigap plans sold in your area.
Can You Enroll in a Medigap Plan After Your Open Enrollment Period?
The short answer is yes – but with restrictions.
Insurers can require medical underwriting if you apply for a Medigap plan after your six-month Open Enrollment Period.
This means they can deny coverage based on your health history, charge higher premiums due to pre-existing conditions, and/or impose waiting periods before covering certain conditions.
Let’s look at Medigap eligibility for those under 65.
Are Medigap Plans Available for Those Under 65?
Medigap plans are not federally required to be offered to Medicare beneficiaries under 65.
However, many states mandate insurance companies to sell at least one Medigap plan to those who qualify for Medicare due to disability or End-Stage Renal Disease (ESRD). Some states offer only a limited selection of Medigap plans for those under 65, while others provide broader options.
If available, Medigap plans for those under 65 often have significantly higher premiums than those offered to those over 65.
When Can You Enroll in a Medigap Plan Under 65?
If your state requires insurers to offer Medigap plans to beneficiaries under 65, you typically have a six-month Open Enrollment Period that begins when you first enroll in Medicare Part B.
During this time, you cannot be denied a Medigap plan due to pre-existing health conditions.
Remember: Insurers must offer you a plan, but premiums are often higher.
If your state does not require insurers to offer Medigap to those under 65, you may have to wait until you turn 65 to enroll in a plan with guaranteed rights.
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State-Specific Help:
Since Medigap rules vary by state, you can access free, state-specific guidance through your State Health Insurance Assistance Program (SHIP). One of our licensed insurance agents can also help you understand your eligibility and explore your coverage options.
Alternative Coverage Options for Those Under 65
If a Medigap plan isn’t available or affordable in your state, you may have other coverage options to help with Medicare’s out-of-pocket costs:
#1. Medicare Advantage (Part C): A bundled alternative to Original Medicare that includes hospital and medical coverage, often with additional benefits and an annual cap on out-of-pocket expenses.
#2. State Medicaid Programs: If you qualify based on income and resources, Medicaid can help cover Medicare-related costs such as premiums, deductibles, and copayments.
#3. High-Deductible Medigap Plans: Some states offer these as a lower-cost alternative, though you’ll have to meet a higher deductible before coverage kicks in.
Can I Enroll at Any Other Times?
You can only sign up outside of the Open Enrollment Period if you have guaranteed issue rights.
Guaranteed issue right examples:
- If you are a member of a Medicare Advantage plan leaving the federal Medicare program.
- You’ve moved out of your Medicare Advantage plan service area.
- You are a Medicare beneficiary with an employer or union health insurance plan that is terminating.
- You joined a Medicare Advantage plan for the first time last year and want to switch back to a Medigap policy.
State-Specific Exceptions: Four states—Connecticut, Maine, Massachusetts, and New York — have guaranteed issue rights for beneficiaries 65 and older. If you are 65 or older and live in one of these states, you can enroll outside the Open Enrollment Period without being subject to medical underwriting.
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Pre-existing Conditions:
It’s important to be aware that 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.
When Is the Best Time to Enroll in a Medigap Policy?
If you do not have guaranteed issue rights, the overall best time to enroll in Medicare Supplement Insurance plans is during the Medigap Open Enrollment Period. Without guaranteed issue rights, a Medigap insurance company can decline applications received outside the Medicare Supplement Open Enrollment Period.
If an insurer accepts your application, the insurance policy may come with exclusions for preexisting health problems if the health conditions were treated or diagnosed within six months of the policy start date.
If you are subject to a waiting period for pre-existing conditions, you can still get Medicare coverage under Original Medicare for covered services. However, you are responsible for all the out-of-pocket health care costs, which Medigap would have otherwise covered.
How to Enroll in a Medigap Plan: A Step-by-Step Guide
Signing up for a Medicare Supplement (Medigap) plan is a key step to getting more complete healthcare coverage beyond what Original Medicare (Parts A & B) offers.
In this section, I’ll walk you through the enrollment process, how to compare companies and rates, and what information you’ll need to get started.
Step #1. Compare Medicare Supplement Plans and Rates
Before enrolling in a Medicare Supplement plan, it’s important to compare:
Company Reputation: We’ll help you look at insurers with strong financial ratings and customer service reviews.
Plan Options: While benefits are standardized (Plan G, Plan N, etc.), pricing varies by company and location.
Premium Rates: Prices differ based on age, location, gender, and tobacco use.
Rate Increase History: Check past rate increases to see how stable the company has been over time.
Step #2. Gather the Information You Need to Enroll
To complete your enrollment, you’ll need:
- Medicare Claim Number (found on your red, white, and blue Medicare card)
- Date of Birth
- Full Name (as it appears on your Medicare card)
- Address & Phone Number
- Premium Payment Method (Bank draft or paper billing)
Step #3. Find the Best Medicare Supplement Plan for You
Once we help you compare companies and rates, the next step is choosing the right plan.
If you want comprehensive coverage, Plan G is the most popular choice, covering all out-of-pocket costs except the Part B deductible.
If you’re looking to save money on premiums and are comfortable with some out-of-pocket costs, Plan N is a great alternative.
Step #4. Enroll Over the Phone
Once you’ve selected a plan, we’ll assist you in completing your enrollment over the phone. This is a simple and quick process that ensures accuracy and convenience.
Step #5. Receive Your Policy and ID Cards
After your enrollment is finalized, you can expect to receive your policy documents and ID cards within 7 to 10 business days after the policy becomes effective.
Signing up for a Medicare Supplement plan doesn’t have to be stressful. By comparing rates, picking the right plan, and sharing the needed info, you can feel confident you’ve done everything to find the best option for you.
Need Some Help?
Picking the right Medicare plan is an important decision, and it’s not always easy.
With Policy Guide, you’ll get access to knowledgeable agents who can help you compare health plans, quotes, and policies so you can make the best choice for your needs. Let us help you find the plan that fits you perfectly!
Sources: Medicare.gov | Hhs.gov
FAQs
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