Unlike Medicare Advantage Plans, seniors can change their Medicare Supplement Plans anytime, as long as they can afford the premium for the plan and answer the health questions on the application. There are some Special Enrollment Periods (SEP) that exempt seniors from answering the health questions – unless they want a plan G or N which then they will still have to answer the health questions.
How healthy do I have to be to enroll in a Medigap plan?
If you can answer the health questions on the application with ‘No,’ then you can change Medigap Plans whenever you want. Most applications have 10-15 health questions. Usually, there will be one set of questions asking if the applicant has any certain declinable conditions, such as Parkinson’s, cancer, MS, HIV or AIDS.
Another group of questions will ask if the applicant has been treated for any certain conditions in the past 2 to 5 years. It’s important to understand that if you have been treated in the past, but not within the timeframe specified by the question – then you should answer ‘No.’ This means some companies will take people who’ve been treated for cancer in the past but not recently – ask your broker for more details.
After submitting the application, the insurance company will do a ‘health-history background check’ that looks at any major operations you’ve had and the medications you take – so it’s important to answer the application truthfully because they will always find out the truth anyway!
When can I enroll in a Medicare Supplement?
The most common enrollment period is the Initial Enrollment Period (IEP), which happens when you turn 65 years old and enroll in Medicare Part A and Part B. During this enrollment period, which starts 3 months before you turn 65 and end 3 months after the month you turn 65, seniors can select ANYMedicare Supplement they want without having to prove insurability by answering the health questions.
In addition to obtaining a supplement, seniors also need to obtain a separate Part D Prescription Plan. Failure to get a separate PDP will incur a monthly penalty fee that will continue to accumulate every month a senior doesn’t have creditable prescription coverage.
What if I’m coming off group health insurance?
Any time someone 65 years or older comes off group health care coverage from their job, they need to enroll in Part B in addition to selecting a Medicare Supplement and separate Part D Prescription Plan – or choose a Medicare Advantage Plan with drug coverage (called a MAPD). Unlike IEP, seniors coming off of group health insurance can only choose certain Medigap Plans (A, B, C, F, K, L) – but since not every company offers every Medigap Plan, you can usually expect to see Plans A, F and sometimes C. Seniors wanting Plan G or N need to answer the health questions on the application to qualify.
What if I’m coming off Medicaid?
Any time seniors come off Medicaid or public assistance, they’re entitled to a guaranteed issue enrollment period, similar to the enrollment period for seniors coming off of group health insurance. During this enrollment period, seniors can enroll in Medicare Supplement Plans A, B, C, F, K or L. As with the group enrollment period, not every company will offer every plan.
What if I’m on disability?
After receiving social security disability benefits for 24 months, you are automatically enrolled in Medicare, which gives you a guaranteed issue opportunity to enroll in a Medicare Supplement Plan A, B, C, F, K or L.
In Ohio, companies aren’t required by law to offer Medigap Plans to those under 65 years old – so it helps to have a Medicare insurance broker to help you sift through companies in your area that will insure someone under age 65. Also, premiums may be higher for those under 65 due to the large possibility that those under 65 are disabled and may cause the insurance company to experience higher-than-normal claims for that age group.
