When Should I Apply for a Medicare Supplement?
The best time to buy a Medicare Supplement is during your Open Enrollment Period. This is the six-month period that starts on the first day of the month you are celebrating your 65th birthday AND are enrolled in Medicare Part B. In some states, open enrollment can also happen before you turn 65 years old, so be sure to ask around for what’s available.
During the Open Enrollment period, insurance providers are prohibited from performing any medical underwriting when you apply for a plan. This means they cannot refuse to sell, charge you higher premiums, or make you wait for coverage to begin.
It is important that you buy a Medigap policy when you are first eligible to get better rates and policy choices. If you forego this free window and apply for a plan late, there is not guarantee that you will get the plan that you want. There’s also no guarantee that you will get approved for any policy, especially if you have a pre-existing illness. In other cases, the insurance provider can charge you a higher monthly fee.
Case for Pre-Existing Health Conditions
The only time that they can make you wait is if it is related to a pre-existing health condition. In fact, some providers will not shoulder the out-of-pocket expenses related to such condition for up to six months, also called the “pre-existing condition waiting period.” Their Medigap coverage will only start coverage after six months.
But this does not apply to all current health issues. Coverage for such can only be excluded if the illness was diagnosed within six months before the Medigap plan starts, also called the “look-back period.” Take note that Original Medicare will still cover anything related to that said condition (even if Medicare Supplement will not), though you will have to prepare for some copayment or coinsurance costs.
Creditable Coverage
Can you shorten the waiting time to get coverage for pre-existing health issues? Yes, you may—if you’re replacing specific kinds of coverage that are classified as “creditable coverage.” This refers to any other healthcare coverage that you had prior to buying a Medigap policy. If you had 6 months or so of continuous creditable coverage, the Medigap provider will not be allowed to make you wait before it decides to cover your pre-existing illness.
Creditable coverage involves a wide range of healthcare issues, but they will only be considered if you didn’t have a break for more than 63 days. Talk to your preferred insurance provider so they can assess if your prior coverage can be counted as “creditable.” Also, if you purchase a Medicare Supplement plan when you have a guaranteed issue right (Medigap protection), the agency cannot use a waiting period.
What if I have Medicare but am under 65 years old?
If you are under 65 years old and have Medicare coverage due to ESRD or a disability, you might not be able to purchase any Medigap policy until you become 65. Federal law does not require insurance companies to offer Medicare Supplements to younger buyers, although some states do require it. Talk to a qualified Medigap advisor to help lay out all your options before making a purchase.
What if you have a current health plan from your employer?
If you are enjoying group health coverage from a union or your or your spouse’s employer, the typical practice is to wait for it to end before availing Medicare Part B. This means that when this coverage ends, you get the opportunity to enroll in Part B without being forced to pay a penalty for late enrollment. Your Medigap Open Enrollment period will start only when you are ready to use it. Take note that this special schedule applies only to this condition.
