Can Medicare Supplement Plans Be Changed at Any Time?

Medicare Supplement, or Medigap, plans help cover some of the out-of-pocket costs associated with Original Medicare Parts A and B. These plans are offered by private insurance companies and are designed to fill “gaps” in Medicare coverage, such as deductibles, copayments, and coinsurance. While Medigap plans significantly reduce unpredictable healthcare expenses, the ability to change these plans is not always available at any given moment. Specific periods and qualifying situations dictate when and how individuals can alter their Medigap coverage.

Changing During Your Initial Enrollment Period

The most advantageous time to enroll in a Medigap plan, or to change plans without health questions, is during your one-time Medigap Open Enrollment Period. This six-month window begins the first month you are both age 65 or older and enrolled in Medicare Part B. During this period, insurance companies cannot use medical underwriting.

Insurers cannot deny coverage, charge higher premiums due to health conditions, or impose waiting periods for pre-existing conditions. This ensures that anyone eligible can purchase any Medigap policy sold in their state, regardless of their health status. This unique, one-time opportunity does not repeat annually.

Changing With Guaranteed Issue Rights

Even after your initial Medigap Open Enrollment Period concludes, federal law provides certain situations where you have guaranteed issue rights. These rights allow you to buy a Medigap policy without medical underwriting, meaning insurers cannot deny coverage or charge more due to your health. You typically have 63 days from the date your prior coverage ends to exercise these rights. Keep documentation, such as termination notices, as proof of your qualifying event.

Several common scenarios trigger guaranteed issue rights. If you lose employer-sponsored group health coverage, including COBRA, you qualify. If your Medigap insurance company goes out of business, leaves the market, or your policy ends through no fault of your own, you have these protections. Moving out of your current Medigap plan’s service area also grants a guaranteed issue right.

Another significant situation involves Medicare Advantage plans. If you joined a Medicare Advantage plan when first eligible for Medicare and decide to switch back to Original Medicare within the first 12 months, you have a trial right to enroll in a Medigap policy. Additionally, if your Medicare Advantage plan commits fraud, fails to meet its obligations, or terminates its contract with Medicare, you generally have guaranteed issue rights to return to Original Medicare with a Medigap plan. Under these federal guaranteed issue rights, you are typically guaranteed access to Medigap Plans A, B, C, D, F, G, K, or L, although Plans C and F are generally not available to those newly eligible for Medicare after January 1, 2020.

Changing Through Medical Underwriting

Outside of your initial Medigap Open Enrollment Period or qualifying for a guaranteed issue right, changing Medigap plans usually involves medical underwriting. This process evaluates your health status, medical history, and other risk factors to determine coverage and price. Insurers may ask detailed health questions, request medical records, or require a physical examination.

Medical underwriting assesses the financial risk of providing coverage. Based on this assessment, an insurance company may deny your application, charge a higher premium, or impose a waiting period for pre-existing conditions. If your health has declined since you first obtained Medigap coverage, switching plans outside of a protected period can be challenging or more costly. While some states have additional rules, health questions are typically a factor when attempting to switch plans.

Steps to Switch Your Medigap Plan

Switching your Medigap plan involves several steps for a smooth transition. Begin by researching and comparing available Medigap plans from different insurance companies. While plans with the same letter designation offer identical basic benefits, premiums and customer service can vary significantly.

Once you identify a new plan, apply for it before canceling your existing policy. This prevents gaps in coverage, ensuring continuous protection. After your new plan application is approved, which typically takes one to two months, you will receive confirmation of your new policy’s effective date.

Most new Medigap policies include a “free look period,” usually 30 days, allowing you to review the policy and confirm it meets your expectations. During this time, you may temporarily pay premiums for both policies. Only after confirming satisfaction with the new plan should you formally cancel your old Medigap policy by contacting your current insurance company.