Why The Medicare Supplement Open Enrollment Is the Best Time to Apply for Medigap

Feb 9, 2023

The best period to enroll in a Medicare Supplement Policy (Medigap) is during the one-time Open Enrollment window. Your chosen insurance company cannot turn you down or ask any medical questions during this time.

Since the Open Enrollment period lasts six months, ensure that you don’t miss it unless you have coverage from a credible source. If you miss your Medigap’s Open Enrollment Period (OEP), expect to pay higher premiums and more limitations on your coverage options.

At The Modern Medicare Agency, we consider it essential to help you establish that the Medicare Supplement Open Enrollment period only happens once for most people. We want you to get its full benefits by answering all your questions.

Why Should I Get Medigap During the Open Enrollment?

When you buy a Medigap Policy during the six-month Open Enrollment window, you avoid several disadvantages of getting it later. These include paying a penalty fee, being denied coverage due to a health problem, and needing medical underwriting.

Therefore, to avoid complications later, you must take advantage of this one chance to get a Medicare Supplement without complications.

When Is Open Enrollment?

The Open Enrollment Period for your Medicare Supplement starts from the first day your Part B coverage takes effect; therefore, if your Part B begins on June 1, your enrollment period ends on November 30.

Unless you are still working, this usually happens when you turn 65. However, you can delay joining Part B if you remain employed after turning 65, activating your Part B and Medicare Supplement when you retire.

People who qualify for Medicare before age 65 because of a disability get an initial Open Enrollment Period lasting six months when their Part B becomes effective. Then, they get a second 6-month window when they turn 65 since many states don’t allow them access to Medicare Supplement Plans.

Can You Apply Earlier for a Medicare Supplement?

Yes, you can apply for a Medicare Supplement earlier. For example, you can submit your application when you get your Medicare claim number, before your birthday, and before your Part B becomes effective.

You can choose the plan you want, lock it in, and once you receive your Medicare ID card, you can sign up for your Medicare Supplement Plan.

What Happens if You Miss Open Enrollment?

We have seen some cases where clients have missed the opportunity to enroll during the Medicare Open Enrollment. For example, in one case, the client had a serious medical condition, and no company would accept him.

He used another option available through a Medicare Advantage Plan, which he activated during the Annual Enrollment Period in his location. Fortunately, most people can get medical Advantage Plans because it’s easier to find one covering chronic health conditions.

One of the major disadvantages of a Medicare Advantage Plan is that you have to see a doctor in their network for the best copays. With a Medicare Supplement, you can see any doctor on Medicare, whereas, with a Medicare Advantage Network, you pay more.

Can I Buy Medigap at Any Other Time?

If you miss the protection of the one-time enrollment, you can buy a Medigap plan any time of the year. However, you will not have the protection offered by the Open Enrollment window, meaning you will have to answer health questions when applying.

In addition, according to the medical underwriting process, the insurer may decline your application unless you fall under the guaranteed issue circumstances. These include losing a group health plan or other Medigap or Medicare Policy without you being at fault.

Therefore, you can buy a plan at any other time, but you are taking the risk of paying higher premiums and answering medical questions. In addition, in some cases, the insurer may deny your application.

California and Oregon have a yearly Open Enrollment window for Medicare Supplements that lasts 30 days, allowing existing Medicare Supplement policyholders to shop around and change plans. However, this window is only for changes to plans.

Why is Open Enrollment Important When Shopping for Medicare Supplements?

As we explained earlier, timing is of the essence regarding your Medicare Supplement options and coverage.

During the six months of the Open Enrollment Period, you can choose any Medicare Supplement Plan without filling in the health questions on the application. Therefore, you don’t need to give the insurer information about any health issues you may have. Furthermore, they are obliged to accept your application and provide the coverage you requested.

The Open Enrollment Period provides the best time to get Medicare Supplemental coverage, ensuring you get the coverage no matter what- even in cases with health conditions that may prevent you from getting insured later.

What About Getting Coverage During the Fall Annual Open Enrollment (Annual Election Period)?

Many people fail to research correctly and believe they can apply for a Medical Supplement plan in the fall Annual Open Enrollment. Unfortunately, the Annual Open Enrollment, or Annual Election Period as it’s also called, applies to enrolling, changing, or dropping Part D and Medicare Advantage Plans and is not an Open Enrollment Period for Medigap.

Unlike Medigap Open Enrollment, that’s effective when your Part B activates and occurs only once; the Annual Election Period runs from October 15 to December 7. It does not entail enrolling in a Medigap plan without underwriting.

Can I Ever Qualify for a Second Enrollment for Medigap?

In some situations, you could have a second Medigap Open Enrollment Period.

People that have Medicare due to a disability before turning 65 have a 6-month Open Enrollment Period that starts from the effective date of their Part B. Then, at 65, they enter Medicare naturally, getting a second Open Enrollment Period. Then, like everyone else, the window for enrollment starts on their 65th birthday, and they have six months to join a Medicare Supplement program.

The chance for a second Open Enrollment Period happens because Medigap carriers are not required to offer Medicare Supplement Plans to people under 65 in some states. Therefore, these people can enroll without having to answer any health questions.

Another situation that allows you to qualify for a second Medigap Open Enrollment is if you retired, got Medicare, Plan B, and a Medigap plan, but dropped it because you returned to full-time work offering you group health coverage.

In that case, when you retire again and sign up for Medicare Part B, your 6-month Open Enrollment Window gets reinitiated, allowing you to qualify for a Medigap plan with no health questions asked.

Medigap Open Enrollment and Guaranteed Issue Explained

If you are still working at age 65 but enroll in Medicare Part A and B and coordinate it with your group health insurance to reduce spending, you will have missed out on your Medigap Open Enrollment period.

In this case, the guaranteed issue law covers you as long as you have maintained your group health coverage with a creditable provider. You get a 63-day guaranteed issue period to enroll in a Medigap plan with no questions. If you became eligible before 2020, this applies to A, B, C, F, K, and L. Anyone eligible after 2020 can apply for A, B, D, G, K, and L without worrying about pre-existing conditions.

If you are not eligible for Plan G under the guaranteed issues rule, you will have to go through medical underwriting to apply.

Get Help With Medicare Deadlines

Whether you want to ensure you don’t miss the Medical Supplement Open Enrollment Period or want to know what to do if you have missed it, you can get help from the team at The Modern Medicare Agency.

The different open enrollment periods can prove quite confusing. Let one of our experienced and licensed agents specializing in Medicare help you find your qualifying enrollment period and plan the best time to get your policy.