When can I enroll in or switch a Medicare supplement plan?
One of your options to add additional coverage to your original Medicare insurance is to enroll in a Medicare supplement plan. Depending on your individual medical and financial needs, enrolling in one of the 8 standardized Medigap policies (available in all states except MA, MN, WI) may be the best way to ensure you can continue to see your doctor, and to rest assured that most if not all of your medical costs will be taken care of when you are on Medicare.
How can I enroll in a Medicare supplement plan for 2025?
When it comes to Medicare enrollment, timing really matters. If you don’t enroll during the time Medicare allows, you may be facing the problem that you are not allowed to join the ideal plan at a later time, or at a higher premium. So make sure to select and join your preferred Medigap policy at the correct time:
Initial Enrollment period for Medicare supplement plans: When you turn 65
In order to purchase a supplemental policy, you must be enrolled in traditional Medicare Part A and B. Typically, most persons are first eligible for Medicare when they turn 65. This is your ‘initial enrollment’ period, which lasts from 6 months prior to your birthday until 6 months after. You may add a supplement plan during your initial enrollment. This is (with rare exceptions) the only time that an insurer cannot deny you coverage, or raise the premium because of a past or existing health condition. As long as you apply when you first became eligible, you won’t have to go through medical underwriting.
Even when your spouse is also on Medicare, you cannot include him or her in your policy. Each person must buy their own policy.
Be aware that some insurance companies will have a ‘pre-existing condition waiting period’ of typically 6 months, before they cover expenses related to this condition. ‘Pre-existing’ usually means that you have been diagnosed or treated within the past half year. While Medicare will still cover costs related to this condition as far as they are part of the Medicare covered services, you will have to pay out of pocket for any amount that is not covered by original Medicare until the end of your waiting period.
Can I still enroll in a Medicare supplement plan if I missed the ‘Initial Enrollment Period’?
If you miss applying for Medicare supplemental insurance during the initial enrollment, you still can do so, but you have not ‘guaranteed right’. Private insurance companies may still elect to sell you a policy, but most likely you will have to go through a health check and meet their medical underwriting requirements. Insurance companies are free to decide whether to accept you or not, and how much to charge you.
In specific, rare cases, you may however have a ‘guaranteed issue right’ – meaning an insurance company must sell you a supplement plan. This exception takes effect if you have Medicare Part A and B, and your current health insurance situation stops for some reason, e.g. because you were enrolled in a Medicare SELECT plan that does no longer service your region, or you move outside the plan’s servicing area.
A better way to apply for a Medicare supplement plan
The annual Open Enrollment Period between October 15th and December 7th is another good time to apply for a Medicare supplement insurance. Even if you have health problems, during the open enrollment period you will be able to get a Medigap policy for the same price as someone with good health would pay.
What to look for when switching Medicare Supplement Plans
Before you start changing your Medigap policy, which you also can do each year during the Open enrollment period, make sure to ask your doctor and other health care providers to make sure they accept your new policy. Before you make your final decision, it’s a good idea to shop around and compare the total costs of your new policy, including any co-payments, co-insurance or deductibles.
Lastly, don’t overlook to add a Part D prescription drug plan to your Medicare supplement plan, as none of the Medigap policies includes prescription drug coverage!
