Medicare Supplement Open Enrollment Period is a once in a lifetime window that allows you to enroll in any Medigap plan without answering health questions.
Carriers cannot deny you coverage if you apply during your Medigap Open Enrollment Period.
What is the Medicare Supplement Open Enrollment Period
- Once in a lifetime window (unless collecting SSDI)
- Window begins once Part B is in effect
- No health questions during this time frame
- Not the same as the Annual Fall Open Enrollment Period
Applying outside your open enrollment window can result in higher premiums, as well as restrict your coverage options. This window only lasts for six months for each new beneficiary, unless you delay enrollment into Part B due to having other creditable coverage.
Your Medicare Supplement Open Enrollment Period is not the same as the annual fall enrollment window. With AEP, the dates to enroll are the same every year. With your individual Medigap Open Enrollment Period, the dates are unique to you.
Your individual Medicare Supplement Open Enrollment Period starts the first day of the month your Part B is in effect.
If your Part B coverage begins April 1st, then your individual Medicare Supplement Open Enrollment Period window will start then and continue for six months, ending September 30th.
For most, this period starts when they age into Medicare at 65 & enroll in Part B. For some; they choose to delay enrolling in Part B due to still working and having creditable coverage with their employer. When they do retire and enroll in Part B, they will initiate their Medicare Supplement Open Enrollment Period.
How to Be Proactive with your Medigap Enrollment in 2020
For those who planned and applied for Medicare early, you’ll be given your Medicare claim number before your birthday month.
If you have your Medicare claim number, we can submit your Medigap application before your Part B effective date. The carrier will process your application as if you’re already in your Medigap Open Enrollment Period, with no health questions.
Once you apply for Medicare, there’s no need to wait to enroll in a supplement plan until you turn 65. With rates constantly changing, we often help our clients lock in their Medigap plan months before their 65th birthday.
Is there an Occasional Secondary Medigap Open Enrollment Period?
There are very few situations where a Medicare beneficiary will get a second Medigap Open Enrollment Period window.
- If you retire, enroll in Part B, then go back to work and join in the employer’s group healthcare coverage, you’ll get a second Medicare Supplement Open Enrollment Period when you retire again and enroll back into Part B.
- If you get Medicare due to a disability under 65, you’ll get two Medigap Open Enrollment Periods. The first one will start with your Part B effective date. The second one will begin when you turn 65.
One reason a beneficiary on Medicare due to disability would choose not to enroll during their first Medigap OEP is that they have minimal options because they’re under 65. Many states are not required to offer all supplement plans to those under 65.
Most states only offer Plan A to those under 65. If they wait to enroll in a Medigap plan when they turn 65 during their second Medigap OEP, they’ll be able to choose from all the programs available to them in their state.
Another reason a beneficiary on Medicare collecting SSDI would not enroll in a Medigap plan during their first Medicare Supplement OEP is that the premiums are too expensive. Unfortunately, most states have astronomically high Medigap premiums for those under 65. Once they age into Medicare and their second OEP begins, the rates quoted will be much more affordable.
Can you Enroll Outside your Medigap Open Enrollment Period
When it comes to Medicare Supplement plans, you can join at any time of the year. If your open enrollment window has passed, you can always still apply. However, you’ll most likely have to go through medical underwriting and answer health questions during the application process.
Outside your one-time open enrollment window, a carrier can deny you coverage due to pre-existing conditions or health issues. The only way around this is if you’re granted Guaranteed Issue Rights do to one reason or another that would qualify you for a Special Enrollment Period.
Some states have unique open enrollment rules, like Connecticut and California. In California, they have a birthday rule that allows you to enroll days surrounding your birthday without answering health questions. In Connecticut, they have a year-round open enrollment window for all beneficiaries. So if you like in one of these states, you have a unique benefit that most beneficiaries don’t get!
How to Take Advantage of Your Medicare Supplement Open Enrollment Period
Timing can affect how much you pay for coverage; how easy coverage is to obtain, and it can significantly determine the options available to you.
The Megiap OEP is the only time you’ll ever get that allows you to enroll in any Medigap letter plan. You’ll be able to avoid having to answer any health questions.
By law, the carrier must approve your application for coverage, regardless of any health issues.
After your individual Medigap Open Enrollment Period has passed, a carrier can choose to deny you coverage based on your current health status.
Many new beneficiaries may have pre-existing health problems that could end up preventing them from getting coverage.
If they enroll as soon as their first eligible, during the one-time individual open enrollment window, these health problems will not prevent them from getting coverage.
That’s why we strive to educate our clients on the importance of enrolling during this once in a lifetime window.
What’s the difference between the Fall Annual Enrollment Period vs. Open Enrollment Period?
The Fall Annual Enrollment Period takes place every year from October 15th through December 7th. During this period, you can enroll, dis-enroll, or change Medicare Advantage as well as Part D prescription drug plans. The majority of new beneficiaries that enroll in a Medicare Advantage plan end up wanting to switch back to Part A & Part B and buy a Medicare Supplement plan. The biggest reason is due to having to stay within the plan’s network of providers and not being able to see their current primary physician.
Many new to Medicare are under the pretense they can enroll in a supplemental plan during the fall Annual Enrollment Period without having to go through medical underwriting questions.
This is one of the biggest misconceptions that causes the most problems for beneficiaries that didn’t have the right resources to educate them on all their enrollment periods. The above is why it’s so important to have a knowledgable agent by your side from the very beginning.
During AEP, you can switch to another Medicare Advantage plan or disenroll from one and enroll back in Part A & Part B. If you return to Original Medicare, you can then enroll in prescription drug plan coverage & Medigap.
If you do enroll in an Advantage plan at any point during the year, you’ll have an opportunity to make changes to it annually during the Medicare Advantage Open Enrollment Period.
Alternative Options When Denied Medigap Coverage Outside Your Individual OEP
When you miss your Medigap Open Enrollment Period and are denied coverage, there are alternative options. If you have a serious health condition that causes a Medigap carrier not to accept you, you should be able to enroll in a Medicare Advantage plan.
Advantage plans only have one health question, and most applicants can pass. However, you’ll have to wait until the fall enrollment period to sign up for one of these plans.
You’ll be required to stay within the plan’s network of doctors. However, if you’re willing to pay more for a PPO plan that gives you access to doctors outside their network, you may be able to keep the same doctor.
What’s the difference between Guaranteed Issue vs. Open Enrollment?
Lots of people end up missing their Medigap Open Enrollment. Mostly due to them still working and being covered under their group employer coverage. They keep their employers’ creditable coverage and enroll in Part A and Part B at 65 to bring their medical costs down.
Once they retire a few years down the road, their Medicare Supplement Open Enrollment Period has come and gone. Thankfully, there’s a law in place for this scenario that protects people. It’s called the guaranteed issue law.
For those who kept their employers’ creditable group health coverage after they enrolled in Part B, they’ll have a 63-day window to enroll once they leave their group plan. During this 63-day window, you’re given guaranteed issue.
The GI 63-day window allows you to enroll in most Medigap plans without having to answer any health questions. If you have any pre-existing health conditions, they won’t be a concern during this time.
Only SOME plans accept Guaranteed Issue. These plans include Medigap Plan A, B, C, F, K, and L. It’s crucial to note that Plan G is not a GI plan for those considered Medicare-eligible prior to 2020. If you did not become eligible for Medicare until 2020 or after, then you can enroll in Plan G with GI rights.
Additional Medigap Open Enrollment Questions
How to Learn More About Your Medigap Open Enrollment Period
At MedicareFAQ, our agents truly care about you. They’ll be able to teach you on all the different enrollment periods to make sure you don’t miss out. If you’re already outside your Medicare Supplement Open Enrollment Period, we’re still here to help you find a plan.
Our agents will be more than happy to answer all your questions and walk you through the health questions to see if you qualify. Our clients also get unlimited support from our Client Care Team.
If you have any issues with claims, appeals, Part D, or want to rate shop, they’re by your side.
Contact us by calling the number above or get help now by clicking here.