- INSURANCE
- HEALTH INSURANCE
You can only switch Medigap plans during open enrollment and in several other situations
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In most cases, you can’t change Medicare Supplement plans at any time. There are only a handful of situations where you can switch Medigap plans, and you must meet certain eligibility requirements to do so. Some states also have unique laws around switching plans.
You might want to change your Medigap plan for a few reasons. For example, if your plan doesn’t provide enough coverage or it’s too expensive, choosing a different plan might be a better option to meet your needs.
KEY TAKEAWAYS
- You can only switch Medigap plans and Medigap providers in specific situations.
- If you have a guaranteed issue right, you can change plans within 63 days without being subject to medical underwriting.
- Some states allow Medigap plan members to switch plans every year around their birthday or on the anniversary of their policy.
- Depending on when you change plans, you can be denied coverage or charged higher rates due to your health.
Can I Switch Medicare Supplement Plans?
It’s possible to switch Medigap insurance plans, but it depends on the timing and your situation.
Under federal Medicare law, you receive only one guaranteed issue Medigap open enrollment period in your lifetime. This six-month Medigap open enrollment period begins the month you turn 65 or when you enroll in Medicare Part B.
During the Medigap open enrollment period, you can purchase any Medigap plan offered in your state. Premiums are usually lower, and insurance companies can’t deny you coverage because of your health.
If you switch plans outside your Medigap open enrollment period, insurance companies can charge higher premiums based on your past or current medical history. Insurers can deny you coverage if you’re in poor health or impose a waiting period before your pre-existing conditions will be covered.
“The biggest risk of changing to a different Medigap plan outside open enrollment is that you must answer health underwriting questions,” said Wilson Coffman, president of Coffman Retirement Group.
However, there are a few situations where you can switch Medigap plans after your open enrollment period ends.
Your State Has a Medigap Birthday Rule
Some states have a Medigap birthday rule, which allows you to switch plans and/or insurance companies around the time of your birthday without medical underwriting.
Depending on the state, you can switch to a different plan within 30 to 60 days of your birthday each year. But in most states, you can only switch to a plan with equal or lesser benefits than your current one.
You Are Within the Medicare “Trial Period”
If you purchase a Medicare Advantage Plan, you have a 12-month “trial period.” You can cancel your Medicare Advantage plan and enroll in Original Medicare during this time. After you make the switch, you can purchase a Medigap plan.
These are two situations that make you eligible for a “trial right” to purchase Medigap:
- You got a Medicare Advantage plan when you were first eligible at age 65, and after the first year, you want to switch to Original Medicare.
- You had Original Medicare and a Medigap plan. Then, you dropped it to join a Medicare Advantage plan for the first time. Within the first year of the Medicare Advantage plan, you want to switch back to Original Medicare.
Enrolling in a Medigap plan with a trial right means you can’t be denied coverage because of your health or charged more for your plan.
You Are Within the 30-Day Free Look Period
Every Medigap plan has a 30-day free look period. During this time, you can switch to a different Medicare Supplement plan and get a full refund. However, you must pay the first month’s premium for the old plan before switching to a new one.
You Have a Guaranteed Issue Right to Switch Plans
You might qualify for a Special Medigap Enrollment period if you have a guaranteed issue right. During this 63-day period, insurers can’t deny you a Medigap plan; they must cover your pre-existing health conditions. Insurance carriers also can’t increase the cost of Medigap insurance because of your current or past health history.
Here are a few of the situations where you can switch Medigap plans with a guaranteed issue right:
- You lose Medigap coverage through no fault of your own, such as the insurance company going bankrupt.
- You move out of the Medicare or Medigap plan network.
- Your Original Medicare plan or employer-sponsored health insurance plan pays after Medicare, and the plan is ending.
State Rules About Changing Medicare Supplement Plans
Some states have specific regulations around Medigap guaranteed issue rights that go above and beyond what is required at the federal level. In the 12 states below, extended Medigap guaranteed issue rights can make it easier to purchase a plan outside of your Medigap open enrollment period.