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Medigap Open Enrollment Period

October 6, 2016

Eligible Medicare beneficiaries have the option to apply for a Medicare Supplement (Medigap) plan at any time during the year. To be eligible to enroll in a Medigap policy, you must already be enrolled in Medicare Part A and Part B. The best time for beneficiaries to enroll in a Medigap plan is typically during their Medigap Open Enrollment Period (OEP). When you enroll during this period, medical underwriting is not required and you generally can’t be disqualified for your chosen plan based on a medical reason. This is especially important for individuals with pre-existing conditions, who may otherwise have issues finding an affordable plan that will accept them. Be aware, however, that you might be faced with a waiting period before your Medigap coverage begins.

Guaranteed-issue right to a Medigap plan

Again, the Medigap Open Enrollment Period is usually a good time to enroll in a Medigap plan because it is a six-month period during which, in most cases, you have the guaranteed-issue right to enroll in your choice of any Medigap plan that’s available in the area where you live. This six-month enrollment period begins on the first day of the month that you are both age 65 and enrolled in Medicare Part B.

Guaranteed-issue rights ensure that a private insurance company does not use medical underwriting to deny coverage to a beneficiary with a pre-existing condition. When you have guaranteed-issue rights, you are not required to fill out a medical questionnaire, answer any medical questions, or take a medical exam before enrolling in a Medigap plan (although waiting periods may apply). Read about other situations where guaranteed-issue rights might apply.

During the months before your Medigap Open Enrollment Period, you may have had other creditable coverage, which covered any conditions that were diagnosed or treated during that time. If you did not have creditable coverage and then enrolled in a Medigap plan, then you may have to wait a period of time before the Medigap plan will cover any health issues that were diagnosed or treated during the six months before your Open Enrollment Period.

Eligibility outside of open enrollment

If you miss your Medigap Open Enrollment Period and wish to enroll in a Medigap policy at a later date, in most cases there is no guarantee that you can enroll in the plan of your choosing. Insurance companies may refuse enrollment based on your health status by using medical underwriting. There may be exceptions as mentioned above. For the best chance of finding and enrolling in a plan that may fit your needs, you may want to enroll in a Medigap policy during your Medigap Open Enrollment Period.

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