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Medicare Supplement Open Enrollment

When you are new to Medicare, you’ll have a one-time window to get a Medigap plan with no health questions asked. This short period begins on your Part B effective date and ends a few months later. After that time, you’ll have to answer health questions when you apply for Medigap, so the Medicare Supplement Open Enrollment period is pretty important.

Sometimes, people confuse the one-time Medicare Supplement Open Enrollment with the Annual Election Period in the fall. Let’s look at the differences between these two enrollment periods.

Open Enrollment for Medicare Supplement.

When people first enroll in Medicare, they are usually coming from group health insurance from an employer. Now that they are retiring, they are switching over to Medicare as their primary insurance. Medicare protects new beneficiaries from pre-existing health conditions that affect Medicare itself. In other words, your Original Medicare benefits will cover you from day one, regardless of your existing health conditions.

Supplemental insurance, however, is offered by private insurance companies. Medicare only requires these companies to give you a one-time six-month window to add Medicare supplemental insurance without health questions. After that time, in most states, the Medicare supplement company can ask medical questions on the application and may turn you down for coverage if there are significant pre-existing health conditions.

For this reason, the Medicare supplement open enrollment window is considered the best time to enroll in a supplement plan. Your application is guaranteed to be accepted and you can apply for any of the 10 standardized Medicare supplement options on the marketplace. As long as your application is submitted before this six-month period ends, you don’t have to worry about any limitations or restrictions on pre-existing health conditions.

It’s important not to confuse this one-time six-month window with the Medicare Annual Fall Open Enrollment period, which is different.

Fall Open Enrollment Period from Oct 15 – Dec 7th.

Every year, Medicare changes the amounts for the Medicare Part D deductibles, initial coverage limits, coverage gap threshold and catastrophic coverage. Companies that offer Part D drug plans or Medicare Advantage plans refile their benefits accordingly. The insurance companies then announce the changes to their plans in September.

Because these changes will likely affect your existing Part D or Medicare Advantage coverage, Medicare gives you an annual election period in the fall. During this short period that runs from October 15th – December 7th each year, you can enroll in, change or dis-enroll from your Medicare drug plan or Medicare Advantage plan.

The annual enrollment period in the fall does not affect your Medigap plan in any way. Therefore, it is not a period during which you can buy Medigap coverage with no health questions.

How to Choose a Suitable Medicare Supplement During Open Enrollment.

Finding the right Medicare supplement during your open enrollment is relatively easy. Review the Medigap comparison chart for a side-by-side comparison of each standardized Medigap plan. Each one covers a different set of gaps in Medicare. Medigap Plans F, G, and N are the most popular.

Once you determine which Medigap plan suits you, an insurance broker can pull a list of all the Medigap companies offering that plan in your zip code.

Review the quotes from the various insurance companies to find the top 3 most competitively priced plans for you. Then, ask your broker for a comparison of those three companies’ rate increase history. You want to choose the carrier that has had the lowest and most stable rate increases for their existing policyholders over the last 5 years.

Though there is no crystal ball, companies with a stable rate increase history are likely to continue to be stable long-term. Choosing one of these carriers is sound judgment.

Once you’ve enrolled in your Medigap plan, you do not have to worry about reviewing it every year in the fall. Medigap plans do not have benefit changes every year like Part D plans and Medicare Advantage plans. The only time you may want to review your Medigap coverage is if you have a rate increase upon the policy anniversary. At that time, you can shop your Medigap insurance just like any other insurance, although health questions will apply in order to change from carrier to another in most states.

Using the Term “Annual Election Period”.

If you find these two open enrollment concepts confusing, here’s an easy tip to help keep them straight. Call the Fall Open Enrollment period the Annual Election Period instead. Changing the word “enrollment” to “election” is one easy way to differentiate the two periods in your mind. Remember that the Annual Election Period in the fall is for Part D plan changes and occurs every year, while the Medigap Open Enrollment only happens once and then is gone.


Written by: Danielle Kunkle from Boomer Benefits