Medicare Supplement Open Enrollment

• Only occurs once for most people. It is not yearly.
• Only lasts for six months. Once the 6 month passes it’s is gone
• Once its gone, you can still apply or change plans but you must answer health questions
• People on Medicare under age 65 will get a rare second open enrollment for Medicare supplement later when they turn 65

Your Medicare Supplement Open Enrollment lasts for only 6 months.

As mentioned above, your personal Medicare Supplement Open Enrollment period begins on the first day that your Part B becomes effective. If your Medicare Part A and Part B coverage started on February 1st, then your personal enrollment period lasts for exactly 6 months and ends on July 31st. The same goes for any other month that you start you Part A and Part B coverage – henceforth 6 months.

For most people this occurs at age 65 when they age into Medicare. However, if you are still working you may delay enrollment into Part B. Later when you retire and enroll in Part B, you can activate your Medicare Supplement Open Enrollment.

If you are on Disability you may qualify for Medicare early. You will get an initial six-month open enrollment period starting with the Part B effective date. Later when you turn 65, you will get a second 6-month window.

If you have applied for Medicare early and you already know your Medicare claim number, you can submit your Medicare Supplement application well in advance of your Part B effective date. The insurance company will still treat it as open enrollment and process it with no health questions asked. We have a lot of clients who apply for their Medicare Supplement plan several months in advance of their birthday month to lock in their plan. Why wait until you turn 65?

A Medicare beneficiary can apply for a Medicare Supplement plan (Medigap) at any time of year. However, he or she must answer health questions on their application and go though medical underwriting. The underwriter can decline you for health reasons unless you are protected by your one-time open enrollment window or a guaranteed issue condition.

Some carriers have an annual open enrollment for Medicare supplements. To qualify for these you must already be on a Medicare supplement and be applying for a change to an equal or lesser benefit plan.

Below is why the timing of you Medicare Supplement (Medigap) enrollment can greatly affect your available options and your ability to get coverage:

Medicare Supplement Open Enrollment Period –  the only period you will ever have during which you can enroll in ANY Medicare supplement plan. If you enroll during this period, you can choose any Medicare Supplement plan – A, B, C, D, F, G, K, L, M or N. You can skip all the health questions on the application. It doesn’t matter if you are healthy or sickly. The insurance company must accept your application and issue you the coverage when you apply during your Medicare Supplement Open Enrollment.

When your Medicare Supplement Open Enrollment window ends, you may be required to answer health questions on an application with the insurance company. The insurance company can accept or deny your coverage based on your health. Some people may have health conditions which will prevent them from getting coverage later. The Medicare Supplement Open Enrollment period is important for many people because of this single most crucial privilege.

Hundreds if not thousands of Medicare beneficiaries every year are confused and make a mistake thinking they can apply for a Medicare supplement plan without health questions during the Fall Annual Election Period. This is a major error, and comes as a rude awakening for people who didn’t do their research ahead of time.

The Open Enrollment period in the fall only applies to Part D drug plans and Medicare Advantage plans. It’s also known as the Annual Election Period (AEP), to help our clients differentiate between the two very different periods check out our chart below.

The AEP runs from October 15th – December 7th every year. During this time, people can join or leave their Part D drug plan. They can switch from one plan to another. They can do the same with Medicare Advantage plans. The AEP is a time when you can get into or get out of a Medicare Advantage plan.

The AEP does NOT give you a free pass into a Medicare supplement without having to answer health questions. You can apply for a new Medicare Supplement plan any time of year, but in most states you must answer health questions and pass medical underwriting to be approved.

If you miss your Medicare Supplement open enrollment and cannot pass medical underwriting to get a policy, Medicare Advantage can be another option.

We had a beneficiary who attended one of our New-to-Medicare meetings in town. He did not know anything about the Medicare Supplement Open Enrollment period and therefore he missed his opportunity. Due to some serious health conditions, no Medicare Supplement company would now accept him.

He has another option by going to a Medicare Advantage. Medicare Advantage plans have only one health question which most people can pass. So during the next AEP, he can join a Medicare Advantage plan.

He would have preferred a Medicare Supplement since they allow you to see any doctor on Medicare. Medicare Advantage plans will require him to use their network of doctors in order to get the best co-pays.

At that point, we advised him about Medicare Advantage PPO plans where he can still access doctors outside the Medicare Advantage network at a higher cost to him. This will at least offer him coverage instead of going with just Original Medicare only and having to pay 20% of what Medicare doesn’t cover.

Medicare Supplement open enrollment window are missed by some because they are still working. They may have enrolled in BOTH Part A and B at age 65 to coordinate with their group health insurance and reduce their medical spending. When they are ready retire a few years later, their Medicare Supplement Open Enrollment window has long passed.

Medicare (Government) has a guaranteed issue law in place for people who missed their open enrollment window because they are still working and covered under their employers group coverage. As long as you’ve maintained creditable employer group health coverage, you will be given a 63-day guaranteed issue window. During your Guaranteed Issue period, you can enroll in Medicare Supplement plan A, B, C, F, K or L with no health questions. You do not need to worry about pre-existing conditions.

CAUTION: Medicare Supplement Plan G is not one of the plans offered under Guaranteed issue rules. Plan G is the new best plan in place of the going away Plan F, so if you really want Plan G, you’ll need to apply for it and go through underwriting.