When Can You Switch Medicare Supplement Plans?
Optimize your Medicare Supplement coverage. Learn the specific circumstances and processes for switching Medigap plans effectively.
Medicare Supplement, or Medigap, plans are designed to help cover out-of-pocket costs that Original Medicare (Part A and Part B) does not pay. These expenses can include deductibles, copayments, and coinsurance. While Medigap plans offer valuable financial protection, the ability to switch between them is not always straightforward and depends on specific timing and circumstances for beneficiaries.
Initial Medigap Enrollment Period
The most advantageous time to enroll in a Medigap plan is during an individual’s Initial Medigap Open Enrollment Period. This six-month window begins the first month an individual is both age 65 or older and enrolled in Medicare Part B. For example, if your Part B coverage starts in June when you turn 65, your Medigap Open Enrollment Period would run from June through November.
During this period, insurance companies cannot use medical underwriting to decide whether to sell a policy or deny coverage. They are also prohibited from charging higher premiums due to existing health conditions. Insurers cannot impose waiting periods for pre-existing conditions during this time. This one-time opportunity offers flexibility and choice, guaranteeing access to any available plan in your area regardless of health status.
Guaranteed Issue Rights for Switching
Beyond the initial open enrollment period, specific situations grant individuals “guaranteed issue rights.” These rights allow individuals to buy certain Medigap policies without medical underwriting. Insurance companies must sell a policy, cannot deny coverage, and cannot charge more due to health conditions. These rights come with a limited timeframe during which they must be exercised.
One common scenario involves the loss of employer group health coverage that supplements Medicare, including COBRA. If such coverage ends, individuals have a 63-day window to purchase a Medigap plan. If an existing Medigap plan’s company goes bankrupt or discontinues coverage in an area, or if a Medicare Advantage plan leaves the Medicare program or stops serving an area, a 63-day guaranteed issue period applies.
Individuals who initially joined a Medicare Advantage plan when first eligible for Medicare Part A at age 65 have a “trial right.” This allows them to switch back to Original Medicare and buy a Medigap policy within the first 12 months of joining the Medicare Advantage plan. This ensures a pathway back to Medigap if the initial Medicare Advantage plan does not meet their needs.
Switching with Medical Underwriting
Outside of the Initial Medigap Open Enrollment Period and specific guaranteed issue rights, individuals face medical underwriting when attempting to switch Medigap plans. Medical underwriting is the process where an insurance company evaluates an applicant’s health status, medical history, and other risk factors. This assessment helps insurers determine whether to offer coverage and at what price.
Medical underwriting can result in the insurer denying coverage based on health conditions or charging higher premiums. Companies ask questions about chronic conditions, medications, and past hospitalizations. While most states require underwriting outside of protected periods, some states have their own specific rules, such as “birthday rules” or continuous open enrollment, that may offer additional opportunities to switch without underwriting.
Steps to Switch Medigap Plans
Switching Medigap plans involves several steps. The process begins with researching available Medigap plans in your area to find one that best fits your needs. This comparison should consider the benefits offered by different plans and their associated premiums.
After selecting a new plan, apply for the new Medigap policy. This involves completing an application form and, if medical underwriting applies, providing detailed health information. Apply for the new plan and receive confirmation of approval before canceling any existing coverage.
Upon receiving approval for the new Medigap policy, you can cancel your old plan. Do not cancel your current policy until the new one is officially active to avoid gaps in coverage. Contact your current insurer directly to cancel. Coordinating the new policy’s effective date with the old one’s termination date ensures continuous coverage and prevents unexpected out-of-pocket expenses.