if you’re currently enrolled in original medicare, part a and part b, you’ll know there may be gaps in your coverage that you have to pay for out of pocket. copays, coinsurance, and deductibles are expenses you are responsible for paying.
That’s where medicare supplemental insurance comes in. Also known as Medigap, Medicare Supplement insurance plans work alongside your original Medicare coverage to help fill in some of those coverage gaps. These plans may pay for certain costs that original medicare doesn’t cover, including cost-sharing and benefits such as overseas emergency medical coverage and medicare part b excess charges (15% of the extra amount original medicare pays). non-participating providers may charge you above what Medicare will pay). for a covered service).
When it comes to Medicare Supplement insurance, the time you sign up can go a long way toward determining the options available to you and how easy it is to find coverage. It can also affect how much you pay for coverage and whether insurance companies can charge you more or deny you coverage altogether based on pre-existing conditions. Read on to learn more about how enrollment works and the best time to enroll in a medigap plan.
when will i be eligible for medicare supplemental insurance coverage?
You’re generally eligible for medigap coverage if you’re enrolled in original medicare, part a and part b.
if you’re under 65 and have medicare, you may not be able to enroll in medicare supplemental insurance; Federal law does not require states to offer Medigap coverage to beneficiaries under the age of 65. However, some states offer certain medigap plans to beneficiaries under age 65 with disabilities or certain conditions, such as end-stage renal disease or amyotrophic lateral sclerosis (Lou Gehrig’s disease). ). Your medigap eligibility and options will depend on your specific state, so contact your state insurance department to see if you qualify for medicare supplemental insurance coverage.
when is the best time to sign up for a medigap plan?
As mentioned, the timing of your enrollment can affect your coverage options and costs. In general, the best time to enroll in a Medicare supplement insurance plan is during your Medigap open enrollment period. This is the six-month period beginning on the first day of the month that you are both age 65 or older and enrolled in Medicare Part B. During this period, you can enroll in any guaranteed issue Medigap plan offered in your service area. this means that insurance companies cannot use your medical history or pre-existing conditions as a basis to charge you more for coverage or deny it altogether. If you have medical problems or disabilities, it’s especially important that you take advantage of this period: Your medigap open enrollment period may be one of the few times when you have a guaranteed right to enroll in any medicare supplemental insurance plan in your area.
once your medigap open enrollment period is over, you may not be able to enroll in a medicare supplemental insurance plan as easily if you’re doing it for the first time. If you’re already enrolled in a medigap plan, you may not be able to switch guaranteed issue plans (except in certain situations). without guaranteed issue rights, you may be subject to medical underwriting and charged higher premiums based on your health status. insurance companies can also deny you coverage if you have health problems. It’s usually more difficult to find Medicare supplemental insurance coverage after your Medigap open enrollment period has passed if you have disabilities or pre-existing conditions; even if you can find a medigap plan that accepts it, your premium costs may be higher.
other situations where you may have guaranteed emission rights
There are some situations where you can still enroll in a guaranteed issue medicare supplemental insurance plan. Those situations may include, but are not limited to:
- Your medigap insurance company went bankrupt or misled you.
- Your medigap coverage ends through no fault of your own.
- You’re enrolled in original medicare and an employer-sponsored group plan, and your employer’s coverage is ending.
- You’re enrolled in a medicare select plan (a type of medigap plan that uses provider networks) and you move out of your plan’s service area.
- You are enrolled in a medicare advantage plan and you move out of the plan’s service area, or your medicare advantage plan leaves the medicare program.
- You signed up for a medicare advantage plan at age 65 when you first became eligible for medicare part a, but you changed your mind during the first year and want to go back to original medicare.
- You dropped your medigap plan to join a medicare advantage plan for the first time, but you changed your mind during the first year and want to go back to original medicare.
Have questions about your rights to medigap coverage or would like help finding medicare supplemental insurance plans that might work for you? contact ehealth for personalized assistance from a licensed insurance agent. Or, if you’d like, you can explore your Medicare Supplement insurance plan options from the comfort of your home. just use the plan search tool on this page to get started.
This website and its content are for informational purposes only. nothing on the website should be used as a substitute for professional medical advice. You should always consult with your medical provider regarding the diagnosis or treatment of a health condition, including decisions about the correct medication for your condition, as well as before engaging in any specific exercise or dietary routine.
Pre-existing conditions are generally health conditions that existed prior to the start of a policy. they may limit coverage, be excluded from coverage, or even prevent you from being approved for a policy; however, the exact definition and relevant coverage limitations or exclusions will vary with each plan, so check the official documents for the specific plan to understand how that plan handles pre-existing conditions.