Like employer health coverage, Medicare plans come with open enrollment periods. That means you cannot buy a Medicare Supplement plan (or any other Medicare plan) any time you want throughout the year. Generally speaking, you will need to use your Open Enrollment Period or the Annual Enrollment Period (AEP) to enroll in a Medicare Supplement Plan.
Medicare deadlines can be confusing but our trained Medicare agents are here to help. Our services are always free; schedule an appointment today to discuss your Medicare needs.
What is a Medicare Supplement plan?
Medicare Supplement plans (also called Hawaii Medigap plans or policies) are purchased to partially or fully cover the out-of-pocket expenses associated with Original Medicare, such as deductibles, copays, and coinsurance. They do not cover additional benefits such as dental care that are often covered in a MA Plan.
Medigap plans can only be paired with Original Medicare (Parts A & B), not a Medicare Advantage (MA) plan.
When can I enroll in a Medicare Supplement plan?
The best time to purchase a Medigap policy is when you first enroll in Part B. During this Medicare Supplement Open Enrollment Period, seniors get a six-month window* to buy a supplement plan without being asked any questions about preexisting health conditions. In other words, insurance companies that offer Medigap plans are not allowed to use medical underwriting during this window. If Medical underwriting were allowed, you could be denied coverage or charged a higher rate based on any existing health conditions.
*While seniors may enroll in Medicare three months before they turn 65, the Medicare Supplement Open Enrollment Period does not begin until you are both 65 or older and enrolled in Medicare Part B. If you are enrolled in Medicare Part B on the date you turn 65, that is the day your Medicare Supplement Open Enrollment Period begins.
Alternately, seniors may purchase a Medigap policy during AEP (October 15-December 7). If this is the window you are using, we recommend applying as close to October 15 as possible because your application will need to go through the underwriting process. Be sure to wait for approval and what your monthly premium would be before canceling your MA plan.
Are there other times I can enroll in a Medicare Supplement plan?
You may be able to enroll in a different Medicare Supplement plan if you have “guaranteed issue” rights. If you have these rights, a plan may not legally deny or make you wait for coverage, or refuse to cover your pre-existing conditions. There are a few situations that could qualify you for guaranteed issue rights, including:
Your Medicare Advantage plan stops providing coverage in your area.
You moved out of your Medicare Advantage plan’s service area.
Your Medicare Supplement plan went bankrupt.
Your Medicare Supplement plan committed fraud or misrepresented itself.
You only dropped your Medicare Supplement plan to use your trial right to try a Medicare Advantage plan but less than a year has passed and you want to switch your coverage back to Original Medicare with the Medigap policy.
Can I enroll in a Medicare Supplement plan if I am under 65?
While most people enrolled in Medicare are 65 years or older, Americans with disabilities or serious health conditions such as permanent kidney failure may qualify for Medicare. So, yes, there are circumstances where people under the age of 65 can enroll in a Medicare Supplement plan. Unlike people over the age of 65, there is no Medicare Supplement Open Enrollment Period for those under the 65-year age threshold. This means that if you are a Medicare beneficiary under the age of 65, you can apply for a Medigap policy at any time.
One thing to know is that insurance companies are not legally required to sell Medicare Supplement plans to people under 65. A Medicare Supplement plan can consider the disability or health condition that qualifies you for Medicare insurance under the age of 65 in their decision on the cost to insure you or in the rejection of your application. Hawaii law ensures that Medicare beneficiaries under age 65 have the same access to Medigap plans as those over the age of 65.
Our independent insurance agents are dedicated to assisting people on Medicare and those who are ready to transition from employer coverage to personal retirement coverage. We help kupuna understand their benefits options and apply for additional coverage, as needed. Because we represent all the major Medicare Advantage and supplement plans in Hawaii, we are able to offer unbiased advice; all at no cost to our clients.
At PBC, our clients are our number one priority and we look forward to getting to know you and your needs. Call us today at (808) 738-4500 to see how we may be of assistance.