When Can I Switch Medicare Supplement Plans?

Medicare Supplement (Medigap) plans are private health insurance policies designed to help cover out-of-pocket costs not paid by Original Medicare. These plans help with expenses such as deductibles, copayments, and coinsurance, filling in the “gaps” to provide more predictable financial obligations. Understanding when and how to switch these plans involves specific enrollment periods and rights, which differ from Medicare Advantage or Part D prescription drug plans.

Medicare Supplement Initial Enrollment Period

The most advantageous time to enroll in a Medicare Supplement plan is during your personal Medigap Open Enrollment Period. This six-month window begins on the first day of the month you are both age 65 or older and enrolled in Medicare Part B. During this timeframe, insurance companies cannot deny you coverage, impose waiting periods, or charge higher premiums based on your current or past health conditions. This means you have a guaranteed right to purchase any Medigap policy offered in your area, regardless of your health status.

This enrollment period is a one-time opportunity that does not repeat. If you do not purchase a Medigap policy during this initial six-month window, you may face medical underwriting if you decide to apply for a plan later. Medical underwriting allows insurance companies to assess your health history and can result in higher premiums or even a denial of coverage based on pre-existing conditions.

Guaranteed Issue Rights

Beyond the initial enrollment period, specific situations grant individuals “guaranteed issue” rights, allowing them to buy a Medigap policy without medical underwriting. These rights typically allow 63 days from the date your previous coverage ends to ensure a seamless transition.

One situation where guaranteed issue rights apply is if you lose or leave certain types of health coverage. For instance, if your Medicare Advantage plan leaves your service area, stops providing care, or you move out of its service area, you gain a guaranteed issue right. Similarly, if your employer group health plan, including COBRA coverage, that pays after Medicare ends, you typically have this right.

Another guaranteed issue right is a “trial right,” which applies if you initially joined a Medicare Advantage plan and decide to switch back to Original Medicare. If you enrolled in a Medicare Advantage plan when you first became eligible for Medicare Part A and decide to switch to Original Medicare within the first 12 months, you have the right to purchase a Medigap policy. A similar trial right exists if you dropped a Medigap policy to join a Medicare Advantage plan for the first time and switch back within the first year. In these trial right scenarios, you can return to your previous Medigap plan or select a new one, typically within the 63-day window.

Furthermore, if your Medigap insurance company goes bankrupt or terminates your policy without cause, you are granted guaranteed issue rights. When exercising guaranteed issue rights, you are able to purchase Medigap Plans A, B, C, D, F, G, K, or L. Plans C and F are only available to individuals eligible for Medicare before January 1, 2020.

Switching Outside of Guaranteed Issue Periods

If you wish to switch your Medicare Supplement plan outside of your initial enrollment period and without a qualifying guaranteed issue right, the process changes. In such instances, insurance companies are permitted to use medical underwriting. This means they can review your health history, pre-existing conditions, and current medical status when you apply for a new policy.

Based on this assessment, an insurer may deny your application for a new Medigap policy, or they may choose to offer you coverage but at a higher premium. This contrasts sharply with the protections offered during the initial enrollment period or under guaranteed issue rights, where health cannot be a factor in coverage decisions or pricing. Some states have their own specific rules, such as annual “birthday rule” enrollment periods or continuous open enrollment.

Steps to Switch Your Plan

When you are ready to switch your Medicare Supplement plan, the process involves several steps to ensure continuous coverage. First, apply for the new Medigap policy you intend to purchase. Do not cancel your existing plan until your application for the new plan has been approved and you have confirmed its effective date.

Once your new Medigap policy is approved and you know its effective start date, you can then cancel your old policy. Contact your current insurer directly to understand their specific cancellation procedures, which often involve submitting a written request. Align the effective date of your new policy and the cancellation date of your old policy as closely as possible to avoid overlap in premiums or periods without coverage. Many new Medigap policies come with a “free look” period, typically 30 days, during which you can review the policy and cancel it if it does not meet your needs, receiving a refund of premiums paid.