How To Switch To Medigap When You Have Medicare Advantage
Switching to Medigap from Medicare Advantage requires some planning. There are several crucial points you should know.
Even if you haven’t considered changing plans before, understanding the process and options is beneficial. Here I’ll discuss when, how and why to consider changing plans.
When Can I Disenroll From A Medicare Advantage Plan?
There are two times to disenroll from a Medicare Advantage plan: the annual enrollment period and the Medicare Advantage open enrollment period. Annual enrollment takes place in the fall from October 15 through December 7.
The Medicare Advantage open enrollment period is one last chance to change your policy for the year. It takes place from January 1 through March 31 each year. There are other enrollment periods available, such as the initial enrollment period for those newly eligible for Medicare.
If changing from an Advantage plan to Medigap is your goal, you need to apply as early as possible. You want to be sure the Medigap plan accepts your application before you cancel your Advantage plan. The most important information any insurance agent will tell you: Never cancel a policy over a quote. It’s best to wait until you have the final plan in your hands before you cancel current coverage.
Can I Be Denied Medigap Coverage?
When Can I Change My Medicare Supplement Policy?
Why Might You Want To Change Medicare Plans?
What Is A Medicare Supplement Plan
Medicare supplement plans are one health insurance option for people with Original Medicare. There are standardized Medicare supplement insurance plans available that are designed to fill the gaps left by Original Medicare . These are sold by private insurance companies as individual insurance policies and are regulated by the Department of Insurance. After age 65 and for the first six months of eligibility for Medicare Part B, beneficiaries have an Open Enrollment Period and are guaranteed the ability to buy any of these plans from any company that sells them. Companies cannot deny coverage or charge more for current or past health problems. If you fail to apply for a Medicare supplement within your Open Enrollment Period, you may lose the right to purchase a Medicare supplement policy without regard to your health.
When Can You Change Medigap Plans
Just as you can enroll at any time of the year , you also can change Medicare Supplement plans at any time. But again, if its not during your Medigap Open Enrollment Period or if you dont have a guaranteed issue right, you must pass the providers medical underwriting process to qualify in most states.
Some states including California, Washington, Oregon, Missouri and some others allow you to change Medicare Supplement plans without going through the underwriting process.
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If You Have Other Coverage
Talk to your employer, union, or other benefits administrator about their rules before you join a Medicare Advantage Plan. In some cases, joining a Medicare Advantage Plan might cause you to lose employer or union coverage. If you lose coverage for yourself, you may also lose coverage for your spouse and dependents.
In other cases, you may still be able to use your employer or union coverage along with the Medicare Advantage plan you join. Remember, if you drop your employer or union coverage, you may not be able to get it back.
Is There A Deadline For Changing Medicare Supplement Plans
No. After your six-month open enrollment period expires, youre free to change plans at will. In most cases, though, theres no reason to switch plans or carriers until youre notified of a rate increase and want to shop for a lower rate. Just realize that all carriers must increase their rates sooner or later to keep up with inflation and healthcare costs.
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Switching Plans Outside Of Your Medigap Open Enrollment Period Without A Guaranteed Issue Right
If you dont qualify for a guaranteed issue right and want to switch your Medigap plan outside of your initial Medigap Open Enrollment Period, your application may include medical underwriting.
If you have pre-existing conditions or health conditions that have developed after you purchased your current Medigap policy, your new plan could have higher premiums than your current plan. Or the insurance carrier who sells the new plan you want could deny you coverage.
Consult with a licensed insurance agent to discuss your options.
What Are The Risks Of Changing My Medicare Supplement Company
There are two potential drawbacks to consider when thinking about changing your Medicare Supplement company. Some people will change their plan letter as well as their carrier. If you switch plan letters, theres a possibility that you might be dissatisfied with the new coverage. To prevent this from happening, we recommend that you go over the details of your plan before you change with your agent so that you can be confident in your choice.
In addition, on occasion, our clients will tell us that they are concerned about switching to a company that might go out of business. Its important to know that the insurance industry is strictly regulated to prevent that from happening, and there are safety nets in place for you. However, to avoid worrying about this, we recommend sticking with companies that have positive AM Best ratings.
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Medicare Annual Enrollment Period
You can join, switch or drop a Medicare Advantage or Medicare prescription drug plan during the Medicare Annual Enrollment Period . AEP is October 15 to December 7. Since it’s the same time every year, you always know exactly how many shopping days you have until you can add or switch coverage during AEP.
Important Enrollment Dates And Qualifications For Medicare Supplement Plans
While you can switch to a new plan at any time, its wise to be strategic about when you enroll in a Medigap plan, change your plan, or drop the plan entirely.
The best time to enroll in Medigap is during your Initial Enrollment Period, which begins three months before your 65th birthday, includes your birthday month, and ends three months after that. Otherwise, you may lose your guaranteed-issue rights, which are standards that allow beneficiaries to buy plans without paying a higher premium based on any preexisting health conditions.
If you lose your guaranteed-issue rights, your insurance provider will conduct a medical underwriting process to determine your health risks before selling you a plan. If your medical history indicates you are likely to incur more healthcare costs in the future, your plan will charge you a higher premium to cover those anticipated expenses.
Can You Be Turned Down For Medicare Supplemental Insurance
You may not be turned down for Medicare supplemental insurance if you have guaranteed issue rights. But if you do not have guaranteed issue rights, insurance companies have the right to deny you coverage if they determine you are too risky to insure because of your health.
Common conditions that may keep you from obtaining Medigap coverage include diabetes and heart disease.
When Can I Change Medicare Advantage Plans
Knowing when you can make changes to your Medicare Advantage Plan is essential for managing your health care.
These enrollment periods, or windows of time when you can add, drop or change your Medicare plans, happen throughout the year. Some periods occur annually and are available to all Medicare enrollees. In contrast, others are only available to new enrollees or for those that meet special requirements.
Not being aware of which enrollment period applies to you can be the difference between obtaining a Medicare Advantage Plan that best fits your needs or being stuck with a plan you dont want for an extended period of time from a financial or coverage standpoint.
To keep you better informed, were breaking down some of the annual and common life-event enrollment periods, so youre not stuck asking, When can I change Medicare Advantage Plans?
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Is Switching From Medigap To Medicare Advantage A Smart Move
If you are about to sign up for the first time and are on the fence between which of the two coverage options you should purchase, we suggest starting with Medigap first.
If you start with Medigap and later switch to a Medicare Advantage, you are guaranteed to be approved on any MA plan at the best price. The reverse is not always true.
So if you start with Medicare Advantage for a few years and then want to switch to Medigap, you usually will first have to answer health questions before being approved. Medigap insurance providers could turn you down or charge you more. Learn about the Medicare Advantage trial right exception.
Once again, we recommend that you first start with Medigap. You are guaranteed to be approved AND you can see how it works for you, if you can afford it, and how your health status evolves. Changing to MA is simple and guaranteed.
When Can I Enroll In A Medicare Supplement Plan
When newly eligible for Medicare, you enter a seven-month Initial Enrollment Period which begins three months before your 65th birthday and ends three months after the month of your birthday. If not automatically enrolled in Medicare Part A and Medicare Part B , you may sign up during this period, as well as choose to join a Prescription Drug Plan or Medicare Advantage Plan with or without prescription drug coverage.
You may also join a Medicare Supplement Plan during part of your Initial Enrollment Period however, the rules are a little different. You only have a guaranteed issue right to enroll in Medigap during your six-month Medigap Open Enrollment Period, or when you have reached your 65th birthday and are enrolled in Medicare Part B. After this enrollment period, you may not have another chance to buy a Medigap policy and if you are able to buy one from an insurance company in the future, it may cost more.
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You Have Dual Eligibility
If youre eligible for both Medicare and Medicaid, then youll have the ability to join, switch or drop your Medicare Advantage Plan or Medicare Prescription Drug coverage. Youll be able to make a change anytime between January through September. Once you make the plan change, itll go into effect on the first day of the following month. You can also change your coverage during your Open Enrollment Period, between Oct. 15 through Dec. 7. However, the changes will not go into effect until Jan. 1.
Understanding The Waiting Period For A Pre
Federal law doesnt require insurers to cover pre-existing conditions for the first six months. The six-month waiting period is also known as the look-back period, meaning insurers can delay coverage for health conditions that you sought treatment for before applying. During this waiting period, Part A and Part B continue to provide coverage for pre-existing conditions.
Once the waiting period ends, the Medigap policy covers costs like deductibles and copays. Its important to understand what the waiting period might mean for your health care needs.
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Why Switch To Medicare Advantage
Medicare Advantage provides all the benefits offered by Medicare Part A and Part B, and most Medicare Advantage plans also include prescription drug coverage. If youre relatively healthy or you dont frequently use healthcare, switching to Medicare Advantage could end up saving you money.
Beyond potential savings, many people switch to Medicare Advantage for supplemental benefits.
Supplemental benefits are items and services that Original Medicare doesnt provide. They can include the typical vision, dental, and hearing benefits, or even a membership to SilverSneakers or Silver& Fit. Recently, however, plans are going beyond typical supplemental benefits and including extras such as an allowance for over-the-counter medications, transportation services, and meal delivery. Many plans offer these benefits as a free perk, while other plans require an additional premium for extras such as dental and vision.
Here is a list of supplemental benefits available through Medicare Advantage and the percentage of Medicare Advantage enrollees who have that benefit as part of their plan:
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Data from Kaiser Family Foundation. Updated 5/18/201
The General Enrollment Period: January 1march 31
This is the Medicare Advantage General Enrollment Period. During this time, a person can switch from Medicare to Medicare Advantage.
However, they cannot switch the other way round during this window. If a person signs up for traditional Medicare during the General Enrollment Period, coverage will start on July 1.
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Can I Change Medicare Supplement Plans During Annual Open Enrollment
You can change Medicare supplement plans at any time of year but in most states you will have to pass medical underwriting to do so.
This is a very common misconception because people get confused about the Annual Election Period that Medicare holds each fall. During this time, you can freely change your Medicare Part D drug plan and/or your Medicare Advantage plan.
This period DOES NOT, however, apply to Medicare supplements, also known as Medigap plans.
When You Change Where You Live
Moving or changing your current living situation usually triggers a Special Enrollment Period for many Medicare enrollees. If your new address isnt in your plans service area or your new address is within your plans service area but offers different options, then youll have the opportunity to change plans.
If you tell your health care plan provider that youre moving, your enrollment period begins the month before the month of your move, plus two months. However, if you tell your health care plan provider after youve moved, then your period begins that month and runs for two additional months.
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Youre Switching From One Medigap Policy To Another:
- If youve had your policy for less than six months and you have a preexisting health condition, you can apply for a new policy anytime within the first six months of coverage. After that time, the insurance provider will likely need to complete a medical underwriting process before selling you a different plan.
Medicare Supplement Plans And Pre
Medicare Supplement coverage for pre-existing conditions can begin immediately if you enroll with guaranteed issue rights. Otherwise, you can expect to wait six months before coverage of your pre-existing condition begins. Pre-existing conditions include cancer, heart disease, and asthma. According to the Department of Health and Human Services, up to 50% of non-elderly Americans have a pre-existing health condition.
While pre-existing conditions dont affect Medicare, they can affect Medigap eligibility. A pre-existing condition can slow down the process when applying for a Medicare Supplement plan.
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When Can You Change Your Medicare Supplement Plan
Already enrolled in a Medicare Supplement plan but want to know how and when you can change it? Read our guide to learn more about this process with tips you should be aware of.
Each Medicare plan and insurance product we feature has been independently selected and reviewed by our editorial team in conjunction with our partners at Medicare Expert USA. If you make a purchase using the links included, Health.com may be compensated.
There are certain restrictions when it comes to changing Medicare Supplement plans.
There are a number of reasons why you might want to change your Medicare Supplement plan.
Medigap Open Enrollment is the best time to change plans.
You don’t have to wait to change policies if you are buying your very first Medicare Supplement plan.
New rules took effect on January 1st, 2020 that you should be aware of.
There may be times when you want to change your Medicare Supplement plan. Perhaps you want a less expensive policy, or you need more benefits. But you should know that there are certain restrictions on changing Medicare Supplement plans. In this guide, we will highlight key information and the dates you need to know in order to choose the right option for you.
Do I Have To Switch Medicare Supplement Plans If I Move To Another State
In the event that you move to another state, you can keep your current Medigap policy. As long as youre still in Original Medicare Parts A & B, theres no need to switch plans unless you feel like thats needed for your best coverage.
However, if you move states and want to switch to a different policy, youll have to check with your insurance company to see if they will offer you a different Medigap policy in your new area. In some cases, you may have to pay more for your new Medigap policy. Additionally, you might have to answer some medical underwriting questions if you are buying a policy outside of your Medigap open enrollment period.
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When Can I Change To Medicare Supplement With Guaranteed
In some cases you may be able to change from a Medicare Advantage plan to a Medicare Supplement plan with guaranteed-issue rights, meaning that the insurance company must accept you as a member and cannot charge you more due to your health condition. However, in some cases the company may be allowed to impose a waiting period on coverage relating to your health condition.
Here are some general circumstances under which you may generally change from a Medicare Advantage plan to a Medicare Supplement plan with guaranteed issue. This list might not include every situation that could give you guaranteed-issue rights. Please note that these situations generally have time limits in most cases, you apply for the Medicare Supplement insurance policy within 63 calendar days after your Medicare Advantage coverage ends.
- You enrolled in a Medicare Advantage plan when you were first eligible for Medicare and you arent happy with the plan, which youve had for a year or less. You generally have a special right to purchase a Medicare Supplement plan if you return to Medicare Part A and Part B within 12 months of enrolling in the Medicare Advantage plan.
- You move to an area your Medicare Advantage plan does not serve.
- Your Medicare Advantage plan no longer serves the area where you live.
- Your plan no longer has a contract with Medicare.