Medicare Supplement (Medigap): The Essentials of Enrollment
Key Takeaways
- Medicare Supplement Insurance (Medigap)Medicare Supplement Insurance (Medigap) is designed to provide coverage that Original Medicare (Parts A and B) does not. Medigap policies are purchased in addition to Original Medicare and have their own monthly premiums you’ll need to pay. is an additional policy that covers gaps in Original Medicare (Parts A and B)Original Medicare is a fee-for-service health insurance program available to Americans aged 65 and older and some individuals with disabilities. Original Medicare is provided by the federal government and is made up of two parts: Part A (hospital insurance) and Part B (medical insurance). .
- Medigap’s six month Open Enrollment Period starts the month you turn 65 and are enrolled in Medicare Part BMedicare Part B is medical insurance that covers Medicare-approved services — such as medically necessary treatment and preventive services — and certain other costs, like durable medical equipment. Medicare Part B is part of Original Medicare. . During this period, Medigap insurers can’t deny coverage or charge higher rates due to pre-existing conditionsA pre-existing condition is an illness, injury or other medical condition you had before you enrolled in your health insurance policy. .
- Enrolling on time can save money down the line.
Medicare Supplement Insurance (Medigap) is extra coverage for costs like co-insurance, copayments, and deductibles. It’s a popular option, too; nearly a quarter of Original Medicare beneficiaries also purchase a Medigap policy.
Do you know when or how to enroll in Medigap? Perhaps more important: Did you know that when you enroll in Supplement Insurance (Medigap) can impact your coverage?
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Am I Eligible for Medigap?
To be eligibleSome health plans require you to meet minimum requirements before you can enroll. , you must enroll in Original Medicare (Parts A and B). Most individuals are automatically enrolled in Medicare Part AMedicare Part A is hospital insurance, which covers the care you receive while admitted to a hospital, skilled nursing facility, or other inpatient facility. Medicare Part A is part of Original Medicare. by their 65 birthday if they’re already receiving Social Security benefits. If you have questions about enrollment into Medicare parts A or B call your local Social Security office.
When Can I Enroll in Medigap?
The easy answer: as soon as you’re eligible. For traditional Medigap customers, the Medicare supplement open enrollmentThe Medicare Open Enrollment Period (OEP), also known as the Annual Enrollment Period, runs from October 15 to December 7 each year and allows you to make multiple Medicare-related changes. In addition, Affordable Care Act Open Enrollment allows changes to non-Medicare coverage from November 1 to December 15.
period lasts for six months. This window begins the month you turn 65 and enroll in Medicare Part B. You must meet both qualifications to be eligible for Medigap’s open enrollment period.
For example, if you turn 65 in January, but your Part B enrollment begins in February, your eligibility begins on Feb. 1 and runs through the end of July.
Still have questions? GoHealth has the answers you need.
What Are Guaranteed Issue Rights?
During your initial Medigap open enrollment period, you have guaranteed issueIf you have guaranteed issue rights, insurance companies are required to sell you a Medigap (Medicare Supplement) policy without any additional conditions.
rights. Insurers can’t charge higher premiumsA premium is a fee you pay to your insurance company for health plan coverage. This is usually a monthly cost.
because of pre-existing conditions or health status. Insurers are required to accept your application for coverage during the open enrollment period. Plus, your coverage is guaranteed renewable if you purchase it at this time, which means it can’t be canceled by the insurer as long as you pay your monthly premium.
You can still purchase Medigap after your open enrollment period, but you may not get the same pricing or coverage levels. Insurers also are allowed to charge more or limit your coverage for pre-existing conditions if you sign up outside of the initial Medigap open enrollment period.
There are a few exceptions, including if you move or must purchase new Medigap coverage. Many states recognize certain life events and may grant Guaranteed Issue Rights to:
- Medicare recipients who lose supplemental coverage through no fault of their own
- Retirees whose former employers cancel their coverage
- Medicare beneficiaries that move to a new state and can’t keep their supplemental coverage
- Beneficiaries who left a Medigap plan to go into a Medicare Advantage plan, but want to return to the Medigap within 12 months of switching
How Do I Enroll in Medigap?
There are two main ways to enroll in Medigap: (1) you can join on your own. Most private insurance companies have access on their websites or by phone; (2) a licensed insurance agent can help you find the right plan and enroll. It does not cost you anything to speak with a GoHealth licensed insurance agent.
How do I know if I’m already enrolled in Medicare Part A?
Does Medigap cover my spouse?
Let’s find your ideal Medicare Advantage plan.
Sources
- Medigap Enrollment and Consumer Protections Vary Across States. KFF.org
- Social Security Office Locator. SSA.gov
This website is operated by GoHealth, LLC., a licensed health insurance company. The website and its contents are for informational and educational purposes; helping people understand Medicare in a simple way. The purpose of this website is the solicitation of insurance. Contact will be made by a licensed insurance agent/producer or insurance company. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. Our mission is to help every American get better health insurance and save money.
Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.