Medicare Supplemental insurance called Medigap is not a government program. Medigap is a private health insurance policy that complements Medicare, the federal health insurance program for people over 65, and certain disabled individuals. Private insurance companies offer Medigap policies, and state and federal law regulate them.
If Medicare is a government program, why isn’t Medigap a government program?
While Medicare is a government program, Medigap is not directly funded or administered by the government. Instead, it is private insurance purchased by individuals who are enrolled in Medicare. They do so to supplement their coverage and help cover out-of-pocket costs such as copayments, coinsurance, and deductibles.
Medicare and Medigap are related but separate programs, and enrolling in one does not automatically enroll you in the other. To be eligible for a Medigap policy, however, you must have Medicare Part A and Part B.
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Does the government manage Medigap enrollment or switching?
The federal and state governments set up specific times when you can enroll in or switch Medigap policy without having to answer questions about your health. These times are referred to as “guaranteed issue rights” or “open enrollment periods”.
During open enrollment, you have the right to enroll in any Medigap policy offered by a private insurance company, even if you have pre-existing health conditions. What´s more, the firms cannot charge you more for the policy due to your health status.
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If you switch Medigap plans outside of open enrollment, you may be subject to medical underwriting, meaning that the insurance company can ask about your health history and may deny coverage or charge you more for the policy based on your health status. Some state governments like California, Nevada, and others have set up special switching periods in their area that allow residents in their states to switch plans without going through Medical underwriting. In these cases, governments call these switching periods “Birthday Rules”, or “Anniversary Rules” (Source).
Senior65.com can help you compare different Medigap policies and carefully consider your healthcare needs and budget when deciding whether to switch plans. You can do this by contacting us at 800-930-7956.