Changing Your Medicare Supplement Plan

Medicare Supplemental Insurance, also called a Medigap plan, can help with the costs of healthcare expenses that Original Medicare does not cover. But sometimes, Medigap plans do not meet the expectations or needs your medical care requires — not to mention the financial strain monthly premiums can put on your budget. While it can be tricky to switch Medigap plans, it is possible depending on your individual situation.

Reasons to Change Your Medigap Plan

There are many reasons why you may choose to change your Medigap plan, especially if your healthcare needs change and your plan is no longer a best-fit option. If you are unsure about keeping your current Medigap plan or switching to something else, consider these common reasons that push people to enroll in new policies:

  • You are paying for extra benefits that you are not using. Your coverage is simply more than you needed and you are now looking to save money by cutting benefits you are not using.
  • You need additional coverage. The plan you originally selected worked great but your health insurance needs have outgrown it.
  • Your monthly premium has increased or become unaffordable.
  • You want to change insurance providers because you prefer a different company or a different health network.

 Extenuating Circumstances

In some cases, you may not have an option about switching to a new Medigap plan. This often occurs when you move to a new region where your current plan cannot provide benefits, but there are other situations when you have a right to change your Medigap plan:

  • You have a Medicare SELECT plan and move out of the network area
  • Your insurance provider goes bankrupt or stops offering coverage
  • You feel that your insurance provider scammed or misled you to enroll in coverage, or did not follow federal and state regulations when enrolling you in a plan
  • You are still within the Medigap Open Enrollment Period (which lasts six months)

Understanding the Medigap Enrollment Period

Changing your Medigap plan involves a little more work than adding or dropping different kinds of Medicare coverage (such as Part D prescription benefits). Initially, you only have one opportunity to sign up for a Medigap plan: during the six-month Medigap enrollment period. This comes around when you first turn 65 and enroll in Medicare Part B Medical Insurance.

During this Medigap open enrollment period — which varies from person to person depending on when your birthday and when you are eligible to enroll in Medicare — you can select from a variety of Medigap plans offered by private insurance companies. During this six-month span of time, you have more options regardless of any health issues you have or pre-existing conditions and can enroll in any plan you choose.

If you still are using health insurance through an employer or union, do not fret: you can still wait to enroll in a Medigap plan. Many people who still have private insurance through their union or job delay enrolling in Medicare Part B. In this case, you will not be penalized for waiting to enroll in Medicare and you will not need to purchase a Medigap plan. After your private health insurance coverage ends, your Medicare Part B enrollment period will open up, and during this time, the six-month clock for purchasing a Medigap plan will begin. But, there is an exception to the delayed benefits rule: if you choose to enroll Medicare Part B while still using employer or union benefits, your Medigap sign up period will begin at the same time. In this case, you will have to consider forgoing a Medigap plan or purchasing one before you really need it to ensure you do not miss out on future benefits you may need. 

When considering a Medigap plan, it is important to enroll as soon as possible, because once the six-month sign up window closes, you may not be able to get additional coverage at all. In some cases, you may still be able to find and enroll in a Medigap plan, but you could pay substantially more based on the insurance provider’s rules and the age you purchase the plan.

After your six-month enrollment window closes, it may be difficult and more expensive to get a Medigap plan — if you are able to enroll in one at all. After your open enrollment period closes, you are not guaranteed coverage and insurance providers are not required to offer you a policy (except for particular situations). In the same vein, it also becomes difficult to switch Medigap policies after your six-month window closes. Legally, private insurance companies must accept your application for a Medigap policy regardless of any health conditions during your initial enrollment window. But after that time, insurers can apply medical underwriting — an evaluation that determines if you qualify for insurance benefits, what levels of coverage and at what cost based on your health conditions and medical needs. When medical underwriting is applied, insurance companies have the right to reject your application for coverage if they believe it would be too costly to insure you, or they can charge higher premiums for the benefits you receive. In the best cases, a Medigap policy may come at the same or similar cost, though price discrepancies are not unusual if you sign up after the enrollment period.

How to Switch Medigap Plans

Switching Medigap plans can be stressful but it does not have to be. First off, if you are considering changing your additional coverage, you will want to identify potential plans that you may qualify for. PolicyZip’s Medicare Specialists can help you determine what plans may best fit your needs prior to making a big switch. In the most basic sense, you will need to apply to the new insurance company for a plan and see if you can receive coverage. If the company chooses to give you health benefits, you can simply notify your previous Medigap provider so that the old coverage can end.

Medigap plans do come with a free-look period that lasts 30 days. This gives you the chance to determine if the new plan will truly work for you before your prior coverage ends. During the free-look period, you’ll pay the premium for both policies for one month before officially making the switch. After the 30 days is up, you will be responsible for fully canceling your old policy or choosing to stick with it, whichever best meets your needs.