Just like the other Medicare coverage options, there are specific rules for Medicare supplement changes. In general, beneficiaries enroll in a Medicare Supplement plan during their Medigap Open Enrollment Period.
Those who wish to apply for or change Medicare Supplement plans outside the Medigap OEP, may have to go through medical underwriting. However, there are some instances when beneficiaries qualify for a guaranteed issue right. This depends on which sate a beneficiary lives in.
Medigap open enrollment
The suggested time to enroll in a Medicare Supplement is during the Medigap OEP. This is a 6-month period that starts when the beneficiary enrolls in Medicare Part B and is at least 65 years of age. Those who enroll during this time do not have to go through medical underwriting. Underwriting is when an insurance carrier can deny coverage due to an underlying medical condition.
Keep in mind, the Medicare Supplement Open Enrollment is entirely different than the Medicare Open Enrollment that takes place annually from October 15th through December 7th.
During the Medicare AEP, beneficiaries can change or drop their Medicare Advantage (Part C) or PDP (Part D) plan. Be sure not to confuse this with the fall Medicare open enrollment period. This period runs from October 15 to December 7 every year. During fall open enrollment, you can enroll in, change, or drop your Medicare Part D prescription drug plan or your Medicare Advantage (Part C) plan. In many states, enrollees do not use this enrollment period to change Medicare Supplement plans.
Guaranteed issue rights
Those who miss their Medicare Supplement OEP may still qualify for guaranteed issue to enroll in or change their Medicare Supplement without underwriting. There are specific circumstances that offer enrollees guarantee issue rights. Review some circumstances that allow for GI rights below:
- Enrollees who live in one of the four GI issue states (CT, NY, NH or MA).
- Individuals who have Medicare A and B as well as employer coverage and are losing their employer plan.
- Beneficiaries who enroll in a MA/MAPD or PACE program when they are first eligible and change their mind within the first year of coverage.
- Those who have a MA/MAPD plan and are moving out of their plan’s service area.
- The MA/MAPD plan the beneficiary enrolls in leaves the service area.
- The Medicare Supplement provider ends coverage through no fault of the enrollee.
- Enrollees who left a Medicare Supplement plan to try an MA/MAPD plan for the first time can re-enroll in a Medicare Supplement within the first year of trying a MA/MAPD plan.
Click here to learn more about GI rights for Medicare Supplement enrollment
What if you don’t qualify for a GI right
Those who do not qualify for a guaranteed issue right but still wish to change their Medicare Supplement plan may need to go through underwriting. If the beneficiary is healthy, most likely they will pass medical underwriting and receive approval for a new plan.
Beneficiaries with pre-existing conditions may be approved for a new plan although they may pay higher premiums. In some instances, the carrier may deny the beneficiary coverage.
Free look period
A free look period is a 30-day window that some Medicare Supplement enrollees can use to decide if they are happy with their new plan choice. This free look is available if a beneficiary changes from one Medicare Supplement to another.
What to remember when switching Supplements
When considering making a change in Medicare coverage, it is a good idea to get advice from a licensed Medicare agent. A licensed agent understands all your coverage options as well as your needs. They can sort out area plans and help guide you to making an informed decision.
Those who enroll in a new plan should not cancel their old plan until their new enrollment is confirmed. Beneficiaries may also want to pay for both plans for the first month in the event they decide not to keep the new plan.
Once the beneficiary is accepted into the new plan, they must cancel their current Medicare Supplement plan. If they do not, they will be charged for both plans. Those who are unsure about keeping the new plan can wait a month and pay for both to make sure they are happy with the new coverage.
Beneficiaries can request cancellations over the phone or in writing. Those who request the disenrollment over the phone should record a reference number for the call. It is also a good idea to make sure payment for the old plan does not continue.
Learn more about Medicare enrollment periods
More Rules for Medicare Supplement changes:
If a beneficiary moves to another state, they can remain in their current Medicare Supplement plan even if it is not offered in the new state. Although the new state may have its own Medicare Supplements that offer a better price point. A licensed Medicare agent can help find plan options in the new area.