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When Can I Enroll in Medigap? *ONLINE ONLY*
September 2023
By Medicare Rights Center

Dear Marci,

I signed up for Medicare a few months ago, and now I want to enroll in a Medigap too. When can I buy a Medigap?

~Jerome (Wichita, KS)

Dear Jerome,

Medigaps, sometimes called Medicare supplemental insurance, are health insurance policies that offer standardized benefits to work with Original Medicare. They are sold by private insurance companies and are designed to cover your deductibles, coinsurance, and copayments. If you have a Medigap, it pays part or all of certain remaining costs after Original Medicare pays first.

But your question brings up a great point: Medigap enrollment rules are different from Original Medicare enrollment rules. If you want to purchase a Medigap policy, you need to learn the best time to buy one in your state. In most states, insurance companies are only required to sell you a policy at certain times and if you meet certain requirements. If you miss your window of opportunity to buy a Medigap, your costs may go up, your options may be limited, or you may not be able to buy a Medigap at all.

Under federal law, you have the right to buy a Medigap policy if you are 65 and enrolled in Medicare and, you buy your policy during a protected enrollment period.

There are two federally protected times to purchase a Medigap:

Open enrollment period: Generally, the best time to enroll in a Medigap policy is during your open enrollment period. Under federal law, you have a six-month open enrollment period that begins the month you are 65 or older and enrolled in Medicare Part B.

Guaranteed issue right: If you miss your open enrollment period, you can also buy a Medigap when you have a guaranteed issue right. If you are age 65 or older, you have a guaranteed issue right within 63 days of when you lose or end certain kinds of health coverage.

At times when you have the right to buy a Medigap policy, an insurance company cannot deny you Medigap coverage or, charge you more for a policy because of past or present health problems.

Before you buy a Medigap, check to see if your state offers additional protections. For instance, residents of New York and Connecticut can buy a policy throughout the year, not just at select times. These two states also require insurers to sell to people with Medicare who are under age 65. Call your State Health Insurance Assistance Program (SHIP) or Department of Insurance to learn more about your right to purchase a Medigap policy in your state.

Even if you don’t have a guaranteed right to buy a Medigap in your state, you may still be able to buy a policy if a company agrees to sell you one. However, know that companies can charge you a higher price because of your health status or other reasons.

I hope this helps!

-Marci

  

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