October 6, 2016
There are many reasons why you might consider switching Medicare Supplement (Medigap) plans. If you’re paying for benefits you don’t use, need more coverage than your current Medigap plan offers, aren’t happy with your insurance company, or simply want to see if there are lower-cost options, it may be a good idea to change Medigap plans or research if better Medigap plans are available.
You may decide to change Medicare Supplement plans because you’re not as healthy as you were when you first bought the policy. Keep in mind that with certain exceptions, federal law guarantees you the right to buy any Medigap plan available in your area, regardless of any pre-existing conditions or disabilities, during your Medigap Open Enrollment Period (OEP). This period generally begins the first month you are age 65 or older, and you have Medicare Part B, but do note that waiting periods may apply. However, if you’re enrolling in a plan outside of your Medigap OEP, an insurance company may require you to undergo medical underwriting, charge you a higher Medigap-plan premium, or deny you coverage for pre-existing conditions. This can make it difficult to switch Medigap plans if you develop health problems.
Switching Medigap plans with guaranteed issue
Some states and insurance companies do offer guaranteed-issue rights after your Medigap Open Enrollment Period (OEP), but you have to meet certain eligibility requirements. Some situations where you may have guaranteed-issue rights outside of Medicare Supplement (Medigap) OEP include:
- The insurance company that offers your Medigap plan goes out of business.
- The Medigap insurance company misled you or broke the rules.
- You’re enrolled in a Medicare Advantage plan, and your plan leaves Medicare, stops covering your area, or you move out of the plan’s service area.
- You have both Original Medicare and employer-based group coverage, and your employer coverage ends.
- You have Original Medicare and a Medicare SELECT plan (a type of network-restricted Medigap plan), and you move out of the Medicare SELECT plan’s service area.
The exact Medigap plans you can join will depend on which situation applies to you and which plans are available in your area. Make sure to always keep a record of any notifications that your insurance company sends you, including mailed letters, emails, enrollment information, and termination notices. You may need these documents when switching Medigap plans to prove you have a guaranteed-issue right.
Switching from Medicare Advantage to Original Medicare
There are some situations where you may have a “trial right” to purchase a Medigap plan. For example, you may enroll in a Medicare Advantage plan when you first become eligible for Medicare Part A, but decide to switch back to Original Medicare and Medigap coverage if you change your mind within the first year of joining your Medicare Advantage plan.
Because Medigap policies don’t cover out-of-pocket costs for Medicare Advantage, many people drop their Medicare Supplement coverage once they join a Medicare Advantage plan. However, you may decide to keep the policy if you think you might want to return to Original Medicare someday, especially since you only have a trial right for the first year after switching to Medicare Advantage. Keep in mind, however, that you’ll need to continue paying a Medigap premium for a policy you won’t be able to use, on top of your Part B premium and Medicare Advantage plan premium.
Under federal law, you may have a trial right to Medigap coverage if:
- You joined a Medicare Advantage plan when you first became eligible for Medicare Part A at age 65 and decided to switch to Original Medicare within the first year. You may join any Medicare Supplement plan offered in your state.
- You had Original Medicare and a Medigap plan and switched to a Medicare Advantage plan, then decided to switch back to Original Medicare within the first year. You can join the Medigap plan you had previously if the same insurance company still offers it or join any Medigap Plan A, B, C, F, K, or L sold in your area.
- You joined Programs of All-inclusive Care for the Elderly (PACE) when you were first eligible for Medicare at age 65, then decided to switch back to Original Medicare within the first year. You have a right to purchase any Medigap plan sold in your state.
- You had Medigap and dropped it to join a Medicare SELECT plan and want to switch back within the first year. You can switch back to the Medigap policy you had previously if the insurance company still sells it. If that plan isn’t available, you can join any Medigap Plan A, B, C, F, K, or L sold in your state.
Medigap free-look period
When switching Medicare Supplement plans, you have a 30-day “free-look period” where you can stay in both your current Medigap plan and your new plan for a month. This period gives you time to try out a new Medigap policy before deciding which plan to keep. If you’re not happy with your new plan, you can cancel the policy and keep your original Medigap coverage. The free-look period lets you switch Medigap plans with peace of mind, knowing you can go back to your old plan within this period if you’re not fully satisfied.
Outside of this period, you’re not allowed to have more than one Medicare Supplement plan. When applying for a new Medigap plan, you must promise to cancel the other policy within 30 days. Make sure you don’t cancel your old policy until after your new policy is in effect. Keep in mind that you’ll have to pay the premium for both plans during that month; in that sense, the free-look period is a bit of a misnomer, since it’s not truly “free.”
Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program.