If you’re enrolling in a Medicare plan and looking into Medicare Supplemental Insurance, you probably have some questions.
It’s quite natural to have questions and look for answers about Medicare Insurance and Medicare Supplemental Insurance (Medigap), and today we’ll look at some of the more common ones and try to demystify them.
What is the open enrollment period for supplemental plans?
The open enrollment period for supplemental plans is a six-month period that starts on the first day the beneficiary is both 1) 65 years of age or older, and 2) enrolled in Medicare Part B.
In other words, on the first day you are at least 65 and are enrolled in Medicare Part B, you will have six months to choose a Medicare Supplemental Insurance plan. This is when you want to sign up: during your open enrollment period, Medigap insurers cannot deny you coverage.
Wait beyond your six months, and it will be much harder to get the coverage you need.
Can you change supplemental plans anytime?
No, you cannot change Medigap supplemental plans at any time. Under the State of Oregon’s Birthday Rule, you have the option to change your policy for 30 days every year, starting on your birthday.
During those 30 days, you can choose a policy of the same type as the one you already had, or you can choose one with lower benefits, with no medical underwriting. This means that the carriers cannot say no to you: they have to sell you the plan.
Note that you cannot, however, choose a plan with higher benefits, not without medical underwriting.
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What is guaranteed issue for supplemental insurance?
The phrase “guaranteed issue” means that if you sign up for a plan, you are guaranteed to be issued it. In other words, the insurer cannot say no to you under a condition of guaranteed issue.
Guaranteed issue applies during your open enrollment period, when an insurer is required by law to sell you the policy of your choice at the best available rate, regardless of your health status.
Similarly, during your Birthday Rule period you are also guaranteed issue – but only for policies of the same type or of a type with lower benefits.
Do I need supplemental insurance with Medicare?
Medicare will not cover all of your health insurance costs, so if you want additional assistance in the event that you need more care, it is probably a very good idea to purchase a Medigap plan.
How much coverage your Medigap plan will provide depends on the plan: F plans cover everything Medicare does not cover, while A and B plans cover some things but have more notable remaining gaps.
If you don’t want to be stuck with the sole responsibility of paying for your care after your Medicare benefits run out, look into getting a Medigap plan.
We can help
Medigap plans can provide important coverage for gaps left by your Medicare benefits. If you read up on the different plans, you’ll be in a good position to take maximum advantage of the best plan for your needs during your Open Enrollment Period, or to find a substitute within the constraints set by the Birthday Rule.