Many Americans rely on health insurance for peace of mind. Insurance often has specific enrollment periods, so achieving that peace of mind means understanding when you can sign up. When applying for health insurance, the right timing can be the difference between complete coverage and a season with gaps that you will need to cover yourself.
Medicare is one insurance option that offers significant freedom in when you can apply and includes supplement plans to help with any gaps in coverage. Having a variety of supplemental plans means you can choose the care you need at the cost you can afford. If your coverage or budget needs to change, you can change your plans whenever you want. There are some considerations, like your Medicare level and your location. The Medicare Supplement plans California offers may have different requirements than those on the east coast.
What Is Your Class of Medicare?
The freedom to select official Medicare Supplement plans (also called Medigap plans) depends on the level of Medicare you’re currently enrolled in. Medicare is divided into “parts.” Part A is in-patient hospital coverage, Part B is insurance for out-patient or non-hospital healthcare services, and Part D covers medication.
To access Medigap, you must already have Medicare Part A and B. In most cases, Medicare Part A and B eligibility begins at age 65, meaning you will likely have eligibility for a Medigap plan at the same time. You simply need to complete enrollment in Part B to activate the Medigap open enrollment period.
Will You Need to Underwrite?
Open enrollment periods are the times that insurance companies allow people to apply. This includes open enrollment periods for when insurers take on new customers with minimal startup cost. There are also other enrollment periods that may be triggered by specific conditions. Enrolling outside of open enrollment may require you to go through an underwriting process. Underwriting means that the insurer can refuse coverage or raise premiums based on pre-existing health conditions. This makes it preferable to aim for open enrollment periods, which Medigap plans also have. Official Medigap open enrollment is the first six months after you turn 65 and are enrolled in Medicare Part B.
Exceptions for Medicare Supplement Plans California
Your location can also affect whether you are required to underwrite for a new Medigap plan. Medicare Supplement plans California, along with Washington, Missouri, and Oregon, are among a handful of states with underwriting exceptions. This means you can enroll for Medigap plans outside of open enrollment without having to go through the medical underwriting process. California is one of a few states with “the birthday rule” meaning you have 60 days of “open enrollment” following your birthday each year when you can shop for a supplement plan without medical underwriting or a new waiting period.
Do You Have Guaranteed Issue Rights?
If you’re hoping to avoid the possibility of medical underwriting for your new supplement plan, check if you qualify for guaranteed issue rights. These are special circumstances, usually addressing matters beyond your control, that can grant you eligibility without underwriting. These include common situations, such as moving to a new area where your current Medicare may not provide service, or opting out of a newly enrolled Medicare Advantage plan. Guaranteed issue rights also apply if your previous Medigap provider has failed to provide the coverage that it should. This can happen if a provider goes bankrupt or doesn’t follow contract agreements.
Is a Change Worth It?
Once you know your availability for changing your Medigap plan, the next challenge is deciding whether to make the change. Some common reasons that people seek new supplement plans include:
Change in Coverage Needs
It is not unusual for your coverage needs to change, whether you need more coverage due to the natural aging process, or you need less coverage as a result of successful treatments that addressed health issues. If you need to adjust coverage, it doesn’t hurt to review Medigap plans to see if a change will help.
Better Pricing
Because Medigap plans come from private insurers, prices sometimes change as they compete for customers. This can benefit you if a different Medigap provider suddenly offers the coverage you need at a lower price.
Timing Your Medigap Change
By understanding your Medicare plan, how to navigate enrollment periods and underwriting, and the possibility of guaranteed-issue rights protection, you can be better equipped to know when and how to change your Medicare Supplement plan.
With time and careful consideration, you can change your Medigap plan when it’s most convenient for you. Work with an experienced Medicare brokerage for help navigating enrollment periods and answering your additional questions.
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