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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:

1. Enrollees who live in one of the four GI issue states (CT, NY, NH or MA).
2. Individuals who have Medicare A and B as well as employer coverage and are losing their employer plan.
3. 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.
4. Those who have a MA/MAPD plan and are moving out of their plan’s service area.
5. The MA/MAPD plan the beneficiary enrolls in leaves the service area.
6. The Medicare Supplement provider ends coverage through no fault of the enrollee.
7. 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.

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Understanding Medicare enrollment periods is crucial if you plan to offer Medicare plans to potential clients. It is also important to those becoming eligible for Medicare or hoping to make changes to an existing plan. We will break down the different Medicare enrollment periods and help beneficiaries make informed decisions.

Initial Enrollment Period (IEP)

The Initial Enrollment Period (IEP) is when a beneficiary first becomes eligible for Medicare. This period is a 7-month window, starting three months before the month you turn 65, including your birthday month, and ending three months after. For example, if your 65th birthday is in May, your IEP runs from February 1st to August 31st.

During your IEP, you can enroll in:

• Medicare Part A (Hospital Insurance)
• Medicare Part B (Medical Insurance)
• Medicare Advantage (Part C) or Part D (Prescription Drug Plan)

Individuals under 65 who qualify due to disability, have their own IEP. The IEP starts the 25th month of receiving Social Security Disability Insurance (SSDI).

Medicare General Enrollment Period (GEP)

If a beneficiary misses their Initial Enrollment Period, they can sign up for Medicare during the General Enrollment Period (GEP). The GEP runs from January 1st to March 31st each year. Coverage begins the 1st of the month after the beneficiary enrolls.

Although the GEP provides a second chance to get Medicare coverage, it’s important to note there may be late enrollment penalties for those who did not sign up for Medicare Part B when they were first eligible, unless they qualify for a Special Enrollment Period (SEP).

Medicare Annual Enrollment Period (AEP)

The Annual Enrollment Period (AEP) is a critical time for those already enrolled in Medicare to make changes to their plans. It occurs every year from October 15th to December 7th. During this period, you can:

• Switch from Original Medicare (Part A & B) to a Medicare Advantage (Part C) plan, or vice versa
• Change from one Medicare Advantage plan to another
• Add or drop a Part D (Prescription Drug Plan)
• Switch from one Part D plan to another

Click here for strategies for the 2025 AEP

Changes made during AEP will take effect on January 1st, 2025. This is the time to review your coverage, compare plans, and ensure that your healthcare needs will be met in the upcoming year.

Medicare Advantage Open Enrollment Period (MA OEP)

Those enrolled in a Medicare Advantage (Part C) plan, can use the Medicare Advantage Open Enrollment Period (MA OEP) to make a one-time change. This period runs from January 1st to March 31st annually. During the MA OEP, beneficiaries can make the following changes:

• Switch from one Medicare Advantage plan to another
• Disenroll from a Medicare Advantage plan and return to Original Medicare
• Join a Part D plan if you return to Original Medicare

Please note, beneficiaries cannot switch from Original Medicare to a Medicare Advantage plan during this period; changes are available only to those enrolled in MA/MAPD (Part C) plans.

Special Enrollment Periods (SEP)

Special Enrollment Periods (SEP) allow beneficiaries to enroll in or change Medicare plans outside of the usual enrollment periods as long as they qualify for them. A few reasons for SEP eligibility include:

• Loss of an employer-sponsored health plan
• Moving to a new location outside the current plan’s service area
• If the beneficiary gains eligibility for Medicaid or other financial assistance programs
• Disaster related emergencies may offer an SEP if an enrollment opportunity was missed
• Those who leave incarceration

SEPs vary in length and timing, depending on the reason for eligibility. For instance, those losing employer coverage, generally have an 8-month SEP starting from the month after their employment ends or group coverage ends (whichever comes first).

5-Star Special Enrollment Period

Both Medicare Advantage and Part D plans are rated on a 5-star scale by Medicare. The 5-star plans are the highest rated. If there is a 5-star plan available the beneficiaries’ service area, beneficiaries can enroll in it using the 5-Star Special Enrollment Period. This SEP allows a one-time switch to a 5-star plan at any point between December 8th and November 30th of the following year.

This election period provides an excellent opportunity to switch to a high-quality plan if there is one available in the beneficiaries’ area.

Key Tips for Navigating Enrollment in 2025

• Know the dates for each enrollment period to ensure an opportunity is not missed.
• Review the current coverage. During AEP, it is important to review your existing coverage and compare it with other available plans. Changes to premiums, coverage options, and provider networks may impact your decision.
• Use the beneficiaries should use all the tools available to them including Medicare agents Annual Notice of change ANOC, evidence of coverage and the Medicare Plan Finder tool on Medicare.gov. All these tools can help to compare plans, coverage, and costs.
• Understanding Medicare can be complex, Medicare agents are available to guide beneficiaries on available plans and options to best fit their needs. Reach out to a Medicare advisor or SHIP (State Health Insurance Assistance Program) counselor for guidance.

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Understanding Medicare enrollment periods for 2025 is essential for making the right coverage is provided at the right time. Whether enrolling for the first time, looking to change, or there is a need for a special enrollment opportunity, it is important to stay informed about key dates and rules to help manage enrollment options effectively.