Can I Change My Supplement Plan Anytime?

Medicare Supplement (Medigap) plans are private health insurance policies designed to help cover some of the out-of-pocket costs that Original Medicare (Parts A and B) does not pay. These costs can include copayments, coinsurance, and deductibles, effectively filling in the “gaps” in your Medicare coverage. While it might seem intuitive to assume you can change your Medigap plan at any time, this is not generally the case. There are specific periods and circumstances during which you can switch plans, often without medical underwriting.

Understanding When You Can Change Your Plan

The most advantageous time to enroll in a Medicare Supplement plan is during your Medicare Supplement Open Enrollment Period (OEP). This one-time, six-month period begins the first month you are age 65 or older and enrolled in Medicare Part B. During this window, insurance companies cannot deny coverage or charge higher premiums based on your health status, including pre-existing conditions. They must sell you any Medigap policy they offer, as this period offers guaranteed issue rights, meaning your application cannot be refused.

Outside of this initial Open Enrollment Period, changing your Medigap plan typically involves medical underwriting. Medical underwriting is a process where insurance companies evaluate your health information, including medical history, current health conditions, prescription medications, and lifestyle choices, to determine eligibility and premium costs. This assessment can lead to a denial of coverage or higher premiums if you have certain health issues.

However, specific situations grant you guaranteed issue rights, allowing you to change plans without medical underwriting. One common scenario is losing employer-sponsored group health coverage that paid after Medicare. If this coverage ends, you generally have a 63-day period to enroll in a Medigap plan without health questions, beginning 60 days before and extending 63 days after your prior coverage ends. Another instance arises if you are in a Medicare Advantage Plan that leaves Medicare, stops providing services in your area, or if you move out of its service area. In such cases, you can switch back to Original Medicare and enroll in a Medigap plan with guaranteed issue rights, typically within a 63-day window.

You also have guaranteed issue rights if you drop a Medigap policy to join a Medicare Advantage Plan for the first time and decide to switch back to Original Medicare within the first 12 months. This “trial right” allows you to return to your previous Medigap plan, or a comparable one if yours is unavailable, without underwriting. If your Medigap insurer goes bankrupt or violates its contract, you may also qualify for guaranteed issue rights. While federal rules outline these protections, some states have additional “Birthday Rule” provisions or other continuous open enrollment periods that allow for annual Medigap plan changes without underwriting.

Key Considerations Before Making a Change

Before changing your Medicare Supplement plan, a thorough evaluation of various factors is essential. All Medigap plans are standardized by the Centers for Medicare and Medicaid Services (CMS) into lettered plans, A through N. This standardization means that a Plan G, for instance, offers the exact same benefits regardless of which insurance company sells it. Therefore, when comparing plans of the same letter, the primary difference will be the premium charged by various insurers.

Comparing premiums from different insurance companies for the identical standardized plan is a crucial step to ensure you are securing the most cost-effective option. You should also consider the deductibles and out-of-pocket costs associated with specific plans. While Plans A, B, C, F, G, M, and N are widely available, some plans like K and L feature cost-sharing arrangements where you pay a percentage of costs until an annual out-of-pocket limit is met. Understanding these variations helps align your coverage with your financial comfort level.

Investigating the reputation of potential insurance carriers is also a worthwhile endeavor. Factors such as customer service quality, efficiency in claims processing, and the company’s overall financial stability can influence your experience. While benefits are standardized, the administrative aspects of your policy can vary significantly between providers.

Finally, it is prudent to assess your current and anticipated future health needs. If your health status has changed or you foresee increased medical expenses, a plan with more comprehensive coverage might be more suitable, even if it entails a higher premium. Conversely, if you are in good health and comfortable with some out-of-pocket expenses, a plan with lower premiums and fewer benefits could be more appropriate. Aligning your plan choice with your evolving healthcare requirements can lead to better financial outcomes and peace of mind.

Steps to Change Your Medicare Supplement Plan

The process of changing your Medicare Supplement plan involves several practical steps, assuming you have already determined when you can make a change and which plan best suits your needs. The first step involves researching and selecting your new plan and insurer. This means identifying the specific lettered plan that aligns with your coverage requirements and then comparing premium costs from different companies offering that same standardized plan.

Once you have identified a new plan, you will need to apply for it. This application process can often be completed online, by mail, or with the assistance of a licensed insurance agent. If you are applying outside of a guaranteed issue period, be prepared to answer medical questions as part of the application, as the insurer will use this information for medical underwriting.

After submitting your application, you will await approval from the new insurance company. This approval is especially important when medical underwriting is involved, as the insurer can deny coverage or impose higher premiums based on your health history. Once approved and your new policy is confirmed, you should then cancel your old Medicare Supplement plan. It is important to avoid canceling your existing policy until your new one is active to prevent any gaps in coverage. You can typically cancel your old plan by contacting your current insurance company directly, often through a phone call or by sending a written request.

When transitioning between plans, pay close attention to the effective dates of both your old and new policies. Your new plan will have a specific effective date, and it is important to ensure there is no overlap or gap in coverage between the two policies. Some states allow a “free look” period, typically 30 days, where you can hold both policies and pay both premiums to ensure the new plan meets your expectations before fully canceling the old one. This period provides a safeguard, but you must still commit to canceling the old plan within that timeframe if you wish to proceed with the new coverage.