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Guide to Medigap Eligibility in 2022

Medigap eligibility requires applicants to be United States citizens or permanent legal residents for at least 5 consecutive years. You also must be enrolled in Part A and Part B. In most states you need to be 65 years or older; however, insurance carriers in a few states offer at least one Medicare Supplement to Medicare beneficiaries under 65 years. Anyone who is at least 65 years old and enrolled in Medicare Parts A & B is eligible for Medigap.

Medigap Eligibility for Those Aging In at 65

Many seniors will have automatic enrollment in Part A when turning 65. In some cases, beneficiaries automatically enroll in Part B. Once you’ve acquired Original Medicare, you can use your Medicare Supplement Open Enrollment Period to select a Medicare Supplement policy.

The best part, when you enroll during this period, there’s no medical underwriting. This only happens once in a beneficiary’s lifetime and lasts for 6 months.

Those new to Medicare have the best opportunity when it comes to Medigap eligibility. Taking advantage of top-quality coverage at the lowest price is the opportunity every beneficiary has when turning 65.

Medigap Eligibility for Those Under 65

Medicare Beneficiaries under 65 don’t have as many Medigap choices. Insurance companies in some states offer beneficiaries under 65 at least one policy.

The policy that is usually available to Medicare beneficiaries under 65 is Medigap Plan A.

Insurance companies know that beneficiaries under 65, receiving Medicare are likely on disability. Those on disability are a higher risk for claims because they need more consistent care. So, the cost of a supplement is usually higher for people under 65.

Those receiving Medicare under 65 should plan to purchase a Medigap plan at 65; this will provide peace of mind and protect your savings from astronomical healthcare expenses.

Medigap Eligibility Period

Yes, it’s possible to apply for a supplement plan and avoid a health screening or waiting period. This is known as a Special Election Period.

If you have an employer-sponsored supplement secondary to Medicare, and that policy ends; you’ll reap the benefits of Guaranteed Issue rights.

When a Medicare Insurance company commits fraud, loses the Medicare contract, misleads you to enroll, or doesn’t meet the Medicare contractual guidelines then find a supplement company with Guaranteed Issue rights.

Medicare Advantage plan beneficiaries can switch to Medigap if they increased the copayments or premium by 15 percent or more, stopped offering the plan, ends their relationship with your provider, or reduced benefits.

How to Get Help Understanding Your Medigap Eligibility

Medigap eligibility is confusing; thankfully there are brokers that can help you understand the most recent information regarding your eligibility.

Whether you’re new to Medicare, over 70 with Medicare, or under 65; our insurance brokers can answer all your questions and walk you through the application.

MedicareFAQ works hard to make Medicare easier for beneficiaries to understand. To compare rates side by side call one of our licensed Medicare experts at the number above or fill out the 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 Medigap Eligibility in 2022

  1. I turn 65 in January and will still be working. Medicare will be secondary. I have diabetes and use an insulin pump. Should I get Medigap coverage? Is there an open enrollment when Medicare goes primary or only when first enrolled?

    1. Hi Willard! You only need to get Medigap coverage if your current employer plan and Part B do not cover all your costs for your diabetic supplies.

  2. 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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