MEDIGAP ENROLLMENT PERIOD
Do you have questions about your Medigap open enrollment period? We’re here to provide answers. Keep reading to learn everything you need to know about your Medicare Supplement open enrollment period.
There are often misunderstandings when it comes to the Medigap open enrollment period. If you don’t do your research, you could miss the period entirely, which could cause serious issues with your finances and healthcare coverage later.
When you turn age 65, you become eligible for both Original Medicare Parts A and B and for Medicare Supplement insurance, which is also called Medigap. Medicare Parts A and B require you to cover certain out-of-pocket expenses, such as copayments and deductibles, that you might want to eliminate.
A Medigap plan covers part or all of your out-of-pocket costs, depending on which plan you pick. Here’s everything you need to know about your open enrollment period and how to use it wisely.
YOUR MEDICARE SUPPLEMENT OPEN ENROLLMENT PERIOD ELIMINATES MEDICAL UNDERWRITING
The chief benefit of the Medigap open enrollment period is that your insurance company can’t subject you to medical underwriting. If you have pre-existing conditions, for instance, the company can’t increase your premium or deny you coverage.
If you wait until your Medicare Supplement enrollment period ends, you become subject to underwriting. You might pay a much higher premium each month for the same coverage, or the company could decline to offer you coverage.
Avoiding those outcomes is as simple as applying for your desired Medigap plan within that six-month period. As you approach retirement age, use a physical or electronic calendar to keep you on track for all the tasks you must accomplish.
MEDIGAP OPEN ENROLLMENT LASTS 6 MONTHS
Your Medigap open enrollment period begins on the first day of the month in which you turn 65. For instance, if you were born on March 18, your open enrollment period begins on March 1. It lasts for six months, which means that, given the dates above, you would need to have a Medicare Supplement policy in place by September 30.
You can, however, begin researching your open enrollment period prior to your 65th birthday. Figure out what plans interest you most out of the 10 Medigap plans.
As you can see from the image above, each Medigap plan covers different aspects of your out-of-pocket healthcare costs. If you choose a more comprehensive option, such as Plan F, you will pay higher premiums. Remember that Medigap plans are separate insurance policies from Medicare Parts A and B.
YOU CAN’T DELAY YOUR OPEN ENROLLMENT PERIOD
You might have heard a rumor that you’re allowed to delay your open enrollment period. While there are a few exceptions, which we’ll cover further below, this rumor has no basis in fact. Everyone gets the same open enrollment period if they want Medicare Supplement insurance.
However, as long as you’re aware of your rights and obligations, you should have plenty of time to apply for the Medigap plan of your choice. Start researching plans about three months before you turn 65 so you can make your choice well before the six-month enrollment period expires.
INSURANCE COMPANIES CAN STILL CONSIDER TOBACCO USE
During your Medigap open enrollment period, an insurance company can’t use traditional medical underwriting. However, they can incorporate tobacco use into their premium calculations. If you smoke or use tobacco in any other way, you must disclose the habit when applying for a Medicare Supplement plan.
What if you have quit using tobacco? If a significant time period has passed since you last used tobacco, you can safely consider yourself a non-smoker. Contact your insurance company to inquire about whether or not you need to include this information on your application.
SOME COMPANIES USE A PRE-EXISTING CONDITION WAITING PERIOD
When you have a pre-existing condition, some companies have a waiting period of up to six months during which the insurance company will not cover any healthcare costs related to that condition. Your policy still begins immediately, and healthcare costs related to other problems remain covered.
Original Medicare will cover those conditions, but you might be responsible for deductibles, copayments, or coinsurance fees that your Medigap plan is supposed to cover. After the waiting period expires, your pre-existing conditions will be covered in full up to the limits of your plan.
MAKE SURE YOU COME TO MEDIGAP WITH CREDITABLE PRIOR COVERAGE
One way to avoid the Medigap pre-existing condition waiting period is to make sure you’re continually covered. For instance, if you’re moving immediately from group coverage through your employer to Medicare and Medigap, the waiting period likely won’t apply. This is called creditable coverage.
Essentially, you need healthcare coverage that covered your pre-existing condition for the six months leading up to your application for a Medicare Supplement plan. This could come from group coverage, personal coverage under the Affordable Care Act, or some other source.
MEDICARE OFFERS TRIAL RIGHTS IN CERTAIN CIRCUMSTANCES
You might have heard of trial rights. These are rights that Medicare affords beneficiaries who want to “try out” various additions to Medicare, such as Medigap, Medicare Advantage, or Medicare SELECT. Your trial right usually gives you the ability to drop an existing coverage plan and choose a Medigap plan as long as you’re within the first year of coverage.
IF YOUR OPEN ENROLLMENT PERIOD ENDS, YOU HAVE FEWER RIGHTS
You don’t want to let your Medigap open enrollment period expire. People are living much longer these days, which means that the choices you make upon retirement can impact decades of your life.
If you have to pay a higher premium for a Medicare Supplement plan, those costs will add up exponentially month after month. You’re better off getting organized early and taking advantage of your open enrollment period.
The Medigap open enrollment period exists to allow consumers to reduce some of their out-of-pocket healthcare costs. If you’re interested in this kind of policy, use Ensurem’s handy Medigap Quoter to get real quotes from insurance companies that operate in your area.
You’ll also want to learn as much as you can about Medicare Supplement insurance so you don’t make any mistakes. Our job is all about Awaring America, so feel free to explore this blog for more information you might find useful.