Medicare Supplement (Medigap): The Essentials of Enrollment
Reviewed by: Selah Lee, Licensed Insurance Agent
Medicare Supplement Insurance (Medigap) is an additional policy that covers gaps in Original Medicare (Parts A and B) .
Medigap’s six month Open Enrollment Period starts the month you turn 65 and are enrolled in Medicare Part B . During this period, Medigap insurers can’t deny coverage or charge higher rates due to pre-existing conditions .
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?
Find a local Medicare plan that fits your needs
To be eligible , you must enroll in Original Medicare (Parts A and B). Most individuals are automatically enrolled in Medicare Part A 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.
The easy answer: as soon as you’re eligible. For traditional Medigap customers, the Medicare supplement open enrollment 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.
Are you eligible for cost-saving Medicare subsidies?
During your initial Medigap open enrollment period, you have guaranteed issue rights. Insurers can’t charge higher premiums 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
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.
What extra benefits and savings do you qualify for?
If you’re receiving Social Security benefits, you’re automatically enrolled in Part A. If you’re not sure, call your state’s Social Security office.
Medigap policies only cover the actual policyholder, not spouses. If you and your spouse both need Medigap coverage, you will need to sign up separately and purchase individual policies. You will each have your own Medigap Open Enrollment Periods. These are six-month windows that begin the month your Part B enrollment starts after you turn 65.