by Russell Noga | Updated June 16th, 2023
Are you a senior looking to bolster the coverage of your Original Medicare Parts A & B policies? Medicare supplement insurance policies, known as “Medigap,” offers a way to handle some or all the out-of-pocket expenses Medicare leaves unpaid or partially paid.
There are ten Medigap plans, all offering a different level of coverage. Plans F, G, and N are the most popular choices in most states. However, to qualify for Plan F, you must be eligible for Medicare before January 1, 2020. If you’re a new Medicare enrollee, Medicare Plan G has the most comprehensive coverage available out of the ten plans.
Regardless of your chosen plan, you must enroll for a Medigap policy at the right time or you’ll have to go through what is called “Medical underwriting”.
Learn what the deadline is for Medicare supplement enrollment, and how can you get a policy and not be turned down.
What Is the Deadline for Medicare Supplement Enrollment?
The first and most common deadline for enrolling in a Medigap plan is the Initial enrollment period lasting for six months from the day of your 65th birthday. The annual enrollment period is a different deadline, running from October 15 to December 7 annually.
The reason for using these two enrollment periods is that you have a “guaranteed issue period” to a Medigap plan during this time. That means the insurer must approve you for coverage, and cannot deny you even if you have pre-existing health conditions.
If you miss the deadlines for the Medigap 6-month annual enrollment period, insurers can ask you to undergo “medical underwriting” before offering you a plan. Underwriting involves answering a questionnaire to determine your health stats.
You’ll need to reveal if you have any pre-existing conditions to the insurer, and they take these into consideration when approving the policy or not.
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What Does Medigap Cover?
Medigap policies offer additional coverage for the out-of-pocket expenses associated with Original Medicare Parts A & B. Let’s break down the plans’ coverage and what you can expect them to pay.
All Medigap plans offer the following benefits.
- Part A coinsurance and hospital costs for up to 365 days after using up Medicare benefits.
- Part A hospice care coinsurance or copayment.
- Part B coinsurance or copayment.
- Blood transfusion costs for the first three pints of blood.
Plans F, G, and N offer additional Medicare Parts A & B benefits.
- Part A deductible.
- Part B excess charges (Plan N doesn’t cover these charges).
- Skilled nursing facility care coinsurance.
- 80% of emergency healthcare costs when traveling outside the US for 60 days. ($250 deductible and $50,000 maximum apply).
Medigap plans don’t cover prescription drugs or preventative treatments like physiotherapy, vision, hearing, and dental services.
They also don’t cover private-duty nursing or stays at unskilled nursing homes. Most plans don’t cover the Part B deductible. However, if you qualify for Plan F, this policy covers this expense.
Who Is Eligible to Enroll in a Medicare Supplement Plan?
To be eligible for a Medigap plan, you must be enrolled in Original Medicare Parts A (hospital) and B (Medical). There are three ways where you become eligible for Medicare.
- You turn 65.
- You have a disability and receive Social Security Disability Insurance for a minimum of 24 months.
- You have grave illnesses like Amyotrophic Lateral Sclerosis (ALS) or End-Stage Renal Disease (ESRD).
Understanding Guaranteed Issue Rights
When purchasing a Medigap policy, your “guaranteed issue rights” refer to your rights to buy a Medigap policy without undergoing medical underwriting outside the open and annual enrollment periods.
There are scenarios where you’re afforded guaranteed issue rights, giving you access to a Medigap plan at any time, provided you meet the qualifying conditions for these protections. Some scenarios where you’re eligible for guaranteed issue rights include the following circumstances.
- You’re within the first year of coverage under a Medicare Advantage plan and want to switch to a Medigap policy. These are called “trial rights.’
- Your Medicare Advantage provider goes bankrupt or shuts down and moves out of your service area.
- Your Medigap provider shuts down, moves out of the service area, or goes bankrupt.
- Your employer’s healthcare plan ends, and you want to enroll in Medicare and Medigap.
What Happens if You Miss the Open Enrollment Period for Medigap?
What happens if you miss your open enrollment period in the six months after turning 65? If you don’t have any of the guaranteed issue rights discussed, your next best strategy is to wait until the annual enrollment period.
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What's the Difference Between Annual Enrollment & Open Enrollment?
The “open enrollment” and “annual open enrollment” periods differ greatly. You only have one open enrollment period, which ends six months after you turn 65. However, the annual open enrollment period runs yearly between October 15 and December 7.
The Annual enrollment period specifically relates to anyone wanting to return to Original Medicare and apply for a Medigap plan, or for those wishing to change their Medicare Part D drug plan.
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Frequently Asked Questions
What is the deadline for Medicare Supplement enrollment?
There is no specific deadline for Medicare Supplement enrollment. However, the best time to enroll is during your Medigap Open Enrollment Period, which starts when you are 65 years old and enrolled in Medicare Part B.
Can I enroll in Medicare Supplement plans outside of the Medigap Open Enrollment Period?
Yes, you can enroll in Medicare Supplement plans outside of the Medigap Open Enrollment Period. However, depending on your circumstances, you may be subject to medical underwriting, which could impact your eligibility or premium rates.
What is the difference between Medicare Plan G and Plan N?
Medicare Plan G and Plan N are similar in coverage but differ in cost-sharing. Plan G provides more comprehensive coverage, including coverage for Medicare Part A and Part B deductibles, while Plan N requires cost-sharing for certain services such as copayments for doctor visits and emergency room visits.
Can I switch from Medicare Plan G to Plan N or vice versa after the Medigap Open Enrollment Period?
Yes, you can switch from Medicare Plan G to Plan N or vice versa after the Medigap Open Enrollment Period. However, depending on your circumstances, you may be subject to medical underwriting and require approval for the policy.
Is there a deadline for changing from one Medicare Supplement plan to another?
There is no specific deadline for changing from one Medicare Supplement plan to another. However, it’s important to consider any waiting periods or pre-existing condition limitations that may apply when switching plans.
Can I be denied coverage when enrolling in a Medicare Supplement plan?
During the Medigap Open Enrollment Period, you have guaranteed access to any Medigap plan without medical underwriting. However, outside of this period, insurance companies may use medical underwriting to determine if you’re approved or not. Call us at 1-888-891-0229 to see if you qualify.
Are prescription drugs covered under Medicare Supplement plans?
No, prescription drug coverage is not included in Medicare Supplement plans. You would need to enroll in a standalone Medicare Part D prescription drug plan for prescription drug coverage.
Can I enroll in a Medicare Supplement plan if I have a pre-existing condition?
During the Medigap Open Enrollment Period, you cannot be denied coverage or charged higher premiums due to pre-existing conditions. Insurance companies all have different underwriting guidelines, so it’s best to call us to see which company will accept you with your current medical conditions.
Can I be dropped by my Medicare Supplement plan if I have a pre-existing condition?
Medigap plans are guaranteed renewable. As long as you were initially approved and you keep paying your monthly premium you cannot be dropped from the plan.
Consult with the Professionals on Medigap Enrollment
We’re available for a free consultation on Medigap enrollment and plans. Reach out to our team of fully licensed Medigap agents at 1-888-891-0229.
Or leave your contact details on our site, and we’ll connect with you. If you want a free quote on a Medigap plan, use the automated tool on our site and get a quote on any Medigap plan right now.
Russell Noga is the CEO and Medicare editor of Medisupps.com. His 15 years of experience in the Medicare insurance market includes being a licensed Medicare insurance broker in all 50 states. He is frequently featured as a featured as a keynote Medicare event speaker, has authored hundreds of Medicare content pages, and hosts the very popular Medisupps.com Medicare Youtube channel. His expertise includes Medicare, Medigap insurance, Medicare Advantage plans, and Medicare Part D.