When Does Medicare Supplement Open Enrollment Occur?
When Does Medicare Supplement Open Enrollment Occur? When you become Medicare-eligible, you have two primary options for coverage:
- Original Medicare: includes hospital insurance (Part A) and medical insurance (Part B)
- Medicare Advantage: an all-inclusive plan that can package Part A, Part B and prescription drug coverage under one plan
Choosing Original Medicare opens up additional options:
- Add a stand-alone Prescription Drug Plan (Part D).
- Add supplemental coverage to lower some of the out-of-pocket expenses inherent in Original Medicare. Medicare Supplement insurance is also known as Medigap because it fills some of the gaps in Original Medicare coverage.
Initial Enrollment Period
Enrollment eligibility begins when you turn 65 years old and are enrolled in Medicare Part B. The Medigap Initial Enrollment Period is six months long and is when most people sign up for Original Medicare.
Medicare Supplement Open Enrollment is the optimal time to buy supplemental insurance because, within this window, insurance companies selling these policies are legally obligated to:
- Sell you any Medicare Supplement plan available in your state
- Charge you no more because of current health conditions or health history
When you turn 65 and have enrolled in Part B, you have six months to buy a Medigap policy without having to go through medical underwriting.
Although the government does not mandate that private insurance companies offer these policies to beneficiaries under 65, some states have passed laws requiring it. Your State Health Insurance Assistance Program (SHIP) and State Insurance Department can inform you of your local rights.
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Guaranteed Issue Rights
Certain situations warrant guaranteed issue rights. Beneficiaries with guaranteed issue rights cannot be declined the right to buy a Medicare Supplement plan even if the application is received outside the open enrollment period.
Examples of situations that may qualify you for this protection:
- You are a Medicare Advantage (MA) member, and the plan no longer covers your service area or discontinues its contract with Medicare.
- You are relocating from the area that your MA plan covers.
- You have had Original Medicare in conjunction with an employer or union group plan, and now you are retiring and losing that coverage.
If you submit your application for Medicare Supplement insurance after open enrollment and do not have a guaranteed issue right, the insurance can use medical underwriting to determine if your application will be accepted. Because of health conditions, an insurer can charge you a higher rate or decline your application altogether.
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