Guide to Medicare Supplement Eligibility in 2022

If you receive Medicare coverage, you are familiar with the out-of-pocket costs Medicare Part A and Part B leave behind. Thus, you should acquaint yourself with the Medigap eligibility requirements to obtain supplemental coverage as soon as possible.

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One of Medicare’s most significant out-of-pocket expenses is the Medicare Part B 20% coinsurance. Once you meet the annual Medicare Part B deductible (if applicable), you are responsible for the coinsurance for any medical costs you accrue through the end of the year. Plus, Medicare Part A requires coinsurance and copayments when you utilize inpatient care.

These are some reasons Medicare Supplement (Medigap) plans are a wise financial decision. Below, we share everything there is to know about Medicare Supplement eligibility so you can get the coverage you require.

Medicare Supplement Eligibility Requirements at 65 and Up

You must meet a few requirements to be eligible for a Medicare Supplement plan.

Medicare Supplement Eligibility Requirements:

  • Enroll in Medicare Part A and Medicare Part B
  • Be a citizen or legal resident of the United States for at least five years
  • Reside in a state offering the Medicare Supplement plan you want at the time of application
  • Undergo medical underwriting if outside of Open Enrollment or a Special Enrollment Period (in most states)

Many seniors will automatically enroll in Medicare Part A at age 65. Some will also automatically enroll in Medicare Part B.

Once you acquire both parts of Original Medicare (Part A and Part B), you can use your Medicare Supplement Open Enrollment to sign up for the Medigap policy of your choice.

When you enroll during this window, you do not need to answer underwriting questions. Thus, any pre-existing conditions in your health history will not impact your admittance to a Medicare Supplement policy. For most people, this is a once-in-a-lifetime opportunity, only lasting six months.

When you first enroll in Original Medicare, you have the best opportunity for Medicare Supplement eligibility. Although you may sign up for a Medicare Supplement plan at any time, the best time to enroll with guaranteed acceptance is the month your Medicare Part B goes active and the five months following. Totaling a six-month open enrollment window. The closer you are to age 65, the better your chance of obtaining top-quality coverage at the lowest price.

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Medicare Supplement Enrollment Periods

After meeting the Medicare Supplement eligibility requirements, you do not become ineligible for Medigap. If you have Medicare Part A and Part B, you can apply for a Medicare Supplement plan anytime. However, that does guarantee admission to the plan.

Under certain circumstances, applying for a Medicare Supplement plan and avoiding a health screening or waiting period outside your Medicare Supplement Open Enrollment Period is possible. This is known as a guaranteed issue period.

Several circumstances permit someone on Original Medicare to sign up for a Medigap plan using a guaranteed issue right. The most common scenario is when you lose employer-sponsored coverage secondary to Medicare. In this case, you may reap the benefits of a Special Enrollment Period with guaranteed issue rights.

Medicare Supplement Eligibility Under 65

People who qualify for Medicare under age 65 due to disability do not have as many Medicare Supplement choices. Not all states offer Medigap plans to those under 65. However, a handful of states require Medicare Supplement plan carriers offer at least one policy to this group of people.

Often, the only Medigap option for someone under age 65 is the least comprehensive; Medicare Supplement Plan A. Still, each state is different, so it is essential to speak with an agent to understand all options available to you.

Insurance companies know those on Medicare under 65 likely receive Social Security Disability (SSDI) benefits. People with qualifying disabilities pose a higher risk for claims because they require more consistent care. So, the cost of a Medicare Supplement plan is usually higher for people under 65.

The upside to obtaining Medicare Supplement eligibility before age 65 is receiving two Medicare Supplement Open Enrollment Periods. Due to your likely limited selection of Medicare Supplement plan options, when you are under 65, you get a second opportunity to enroll in Medicare Supplement coverage for six months following your 65th birthday.

Even if you reach Medicare Supplement eligibility under 65, you should plan to purchase a Medigap plan during your second Medigap Open Enrollment Period when you age into Medicare. Doing so will provide peace of mind and protect your savings from astronomical healthcare expenses.

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How to Get Help Understanding Your Medigap Eligibility

Now that you better understand who is eligible for Medigap, you can make more informed choices about your healthcare. Our team of licensed Medicare agents and experts is here to help.

Whether you are new to Medicare, or a seasoned pro, we can answer all your questions and walk you through the application process.

At MedicareFAQ, we pride ourselves on putting education first. With the proper knowledge, you can make the best possible choices. No one knows what works best for you better than you, and we know how to use that information to find the best policy.

To compare rates side-by-side, call one of our licensed Medicare experts at the phone number above or fill out our online rate form.

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Jagger Esch

Jagger Esch is the Medicare expert for MedicareFAQ and the founder, president, and CEO of Elite Insurance Partners and Since the inception of his first company in 2012, he has been dedicated to helping those eligible for Medicare by providing them with resources to educate themselves on all their Medicare options. He is featured in many publications as well as writes regularly for other expert columns regarding Medicare.

4 thoughts on “Guide to Medicare Supplement Eligibility in 2022

  1. I am enrolled in Medicare Part A&B and Part D subscription Plans. But part D insurance Prescription Plan with CareMark(Silverscript )does not include the medications for Diabetes that I need. Can I switch plans for PartD to another insurance that does cover (before the regular enrollment Period?


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