Supplemental Medicare Plan vs. Open Enrollment Period

Supplemental 2020 Medicare Plan vs. Open Enrollment Period

When can I buy a Medicare supplemental plan?

Medicare supplemental plans (Medigap), sold by private insurance firms, can help pay for some of the out-of-pocket costs not covered by Medicare Part A and B, such as deductibles, co insurance & co payments. In many cases, you will have an open enrollment period of the Medicare Supplement of 6 months beginning from the 1st month you are age 65 or older and signed up for Part B.

Within the open enrollment period, you have a guaranteed right to buy whatever Medicare supplement plan that will be sold in your country of residence, regardless of your health status. You cannot be refused for health reasons or charged a higher premium. However, you may be liable to a waiting period before your health coverage begins.

What will happen if I do not sign up for a Medigap policy during the open enrollment period?

Should you choose to apply for a Medicare supplement policy after the open enrollment period of your Medicare supplement has expired, it may be difficult to get a Medicare supplement plan or it may cost you more. Outside of the Medicare Supplement’s open enrollment period, an insurance company can use the medical underwriting guidelines to help you determine whether or not to accept your application and provide you with Medicare Supplement insurance coverage when you review your application.

The medical risk assessment usually collects information about your health status and medical history when interviewing or interviewing you or when requesting your medical records. If the insurance company accepts your request, you may be charged a higher premium than other plan members if you already have a medical condition.

Special circumstances in which your rights are guaranteed

Under certain circumstances, you may have guaranteed issue rights (i.e. insurers cannot deny you Medigap coverage or charge you more for a pre-existing condition), also after the Medicare Supplement Period. These situations may include:

The insurance company that provides your Medicare supplement plan will abort the plan (e.g. it filed for bankruptcy) thereby causing you to lose your coverage

You signed up for a Medicare SELECT policy (a type of Medicare supplement plan for which you may need to use providers in their network) now you have left the plan’s service area

You have a group health plan sponsored by an employer or by a group that is terminating and you signed up for Part B of Medicare.

You signed up for a Medicare Advantage plan and, when you moved out of the plan’s service area, returned back to Medicare Part A and B again.

You signed up for Medicare Advantage plan when you first qualified for Medicare, and used a “trial right” in a bid to return to Medicare, Part A and B, within 12 months of the date of your enrollment.  You have changed from a standard Medicare supplemental plan to a Medicare SELECT plan and have used “trial right” in a bid to switch to a Medigap policy within 12 months after the date of the Medicare SELECT purchase date.