Many Americans who are receiving Original Medicare insurance benefits from both Part A (hospital insurance) and Part B (medical insurance) find that their out-of-pocket costs are higher than they would like. For them, having a Medicare supplement, or Medigap plan, is a great solution.
Medigap Supplement insurance plans are sold by private insurance companies to work together with Original Medicare Parts A and B by covering additional health care costs like copayments, coinsurance, and some deductibles.
Today there are over 14 million Americans who have a Medigap plan to supplement their Medicare coverage. If you are closing in on age 65, you may be preparing to enroll in Medicare. You may also be thinking about getting a Medigap plan but are concerned about your options for making plan changes if the need arises.
Many people worry about being tied to the same plan forever and decide not to look into Medigap. But you may be able to change your Medicare Supplement plan. Here are some of the facts that may help you decide about what is best for you.
Making Changes to Your Medigap Plan
You can sign up for a Medicare Supplement plan when you are both 65 years of age and enrolled in Medicare Part B. You cannot be rejected for a Medicare supplement plan if you are enrolled in Original Medicare Parts A and B and if you are purchasing the plan during your six months open enrollment period which begins the month that you turn 65 years old, or you have guaranteed issue rights for another reason.
After your initial 6-month enrollment period, you may be subject to medical underwriting and can be turned down or charged more for a policy. An insurance provider offering Medicare Supplement plans is not required by law to accept you unless you have guaranteed issue rights.
What are Guaranteed Issue Rights?
Guaranteed issue rights, also called Medigap protections, are your protection against being rejected by private insurance companies from purchasing Medicare coverage through supplemental insurance plans. You have guaranteed issue rights if you are in any of the following situations:
• You have Medicare insurance through a Medicare Advantage (Part C) plan and this plan is either leaving Medicare or it stops providing coverage in your area. Or, if you move out of the service area covered by this plan.
• You have Original Medicare and are also covered by your employer’s group health plan or a union plan which offers extended coverage after Medicare pays, but this plan is coming to an end.
• You have Original Medicare and Medicare Select but you move out of Medicare Select’s coverage area.
• When first eligible for Original Medicare, you had a Medicare Advantage (Part C) plan but decided to switch back to Original Medicare.
• You had a Medigap policy initially, switched to a Medicare Advantage plan which you have had for less than a year, and you want to switch back to a Medigap policy.
• The private insurance company where you purchased your Medigap policy goes bankrupt or your Medigap policy ends in another way which is not your fault.
• You drop a Medicare Advantage or Medigap policy because the insurance company has been fraudulent or has misled you.
You are not obligated to stay with the same Medigap policy forever. There are many reasons you may wish to switch from one plan to another. You may discover that you need more, or less coverage, and another plan may be better suited to your coverage requirements. You may also decide to change your policy because you want to move to a different insurance provider. Sometimes people need to change their plans because they are moving to a new area or state.
No matter what the reason, you are able to change your Medicare Supplement plan at any time. Just be aware of the fact that you can be rejected or charged more if you do not have guaranteed issue rights. You can get more information from a representative of the private insurance company that is offering the Medicare Supplement plan you are interested in.
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