Medigap: 7 Ways to Qualify for Guaranteed Issuance

Ways to get Medigap after your initial enrollment period passes

by Amy De Vore+ on Nov 21, 2014 | 33 Comments

Medigap plans are supplemental insurance plans that work alongside Original Medicare. Most people realize there is a Medigap initial enrollment period that begins when you are first eligible for Medicare, but you also have guaranteed issuance if you enroll during a Medigap Special Enrollment Period. You usually have 123 days to do so (60 days before your current plan expires and 63 days after). The following are the seven ways to obtain Medigap without having to endure a waiting period or health screening.

 

 

1) Employer-Sponsored Retiree Plan Ends

You will be able to enroll in a Medigap plan if your employer-sponsored retiree plan that supplements Medicare ends. Note this does not apply if your plan provided primary benefits or if you stopped paying your premium.

California allows for 2 more ways to enroll in Medigap after your initial enrollment period.

2) Reduction of Benefits or Loss of Eligibility of Employer Plan

You are able to get Medigap with guaranteed issuance if:

  • If your employee-sponsored retiree plan continues to offer benefits but ends your supplemental coverage
  • If you lose eligibility due to divorce or death of primary member
  • If your employee-sponsored retiree plan no longer pays Medicare Part B coinsurance

3) Benefit Change or Termination of Your Medicare Advantage Plan

If your Medicare Advantage plan increased your premium or copayments by 15% or more, reduced your benefits, stopped offering the plan, or ends its relationship with your provider, then you have a right to buy a Medigap Plan BUT only from the same Medicare Advantage company (either organization, network, or organization). If the company does not sell Medigap Plans you can purchase from another company. It is important to note than an MA plan may at anytime discontinue its contract with a provider

4) Moving Out of a Medicare Part C Area of Coverage

If if you move out of the area of your Medicare Advantage (MA) plan or Program for All-Inclusive Care for the Elderly (PACE) organization you can enroll in Medigap. You can do this even if an MA plan or PACE organization are available in your new area.

5) Medicare Finds that a Health Plan Commits Fraud, Etc.

You may enroll in Medigap with guaranteed issuance if your health plan, contracted through Medicare, does one of the following:

  • Health plan commits fraud
  • Health plan loses its contract with Medicare
  • Health plan mislead you when you enrolled
  • Health plan does not meet its Medicare contractual obligations

6) Medicare Trial Period

If you joined a Medicare Advantage plan or PACE organization when you first became eligible for Medicare at 65, you may switch to a Medigap plan within the first 12 months of enrollment with guaranteed issuance. However if you were previously in either a MA or PACE and already switched, you would not be eligible for the guaranteed issuance.

7) Medicare Trial Period: Take Two

If you switch from a Medigap plan to another health plan contracted with Medicare, but decide within the first 12 months that you want to go back to your previous Medigap plan, you can. If your original plan is not available, at that time, and only in this case, you can choose any available Medigap Plan and from any provider. However, if you were originally with MA or PACE then switched to Medigap then back to MA or PACE (I know it makes your head spin) you cannot switch back to Medigap.

For help with switching into a Medigap plan with guaranteed issuance during your Special Enrollment Period or joining a plan at any other time call the number above or click here if you’re ready to get a Medigap instant quote.

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Reader Comments and Questions

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By Debe on June 18, 2018

I have medicare part A and B. I started medicare part A in 1999 on disability but remained covered under my husbands health care plan with his employer. He passed away in 2015, and with all the confusion i did not apply for Part B until 2018. I am applying for supplemental insurance now. I am wondering if I can still apply for part D, i applied for B in January 2018, and which would be best for me regarding standard or preferred plans.

Debe,
If you are now over 65, you should still have up to 6 months after your part B effective date to enroll in Medigap without answering health questions. We can help you enroll in any top medicare supplemental plan at no additional cost, so please give us a call.

Part D deadlines works differently. If you are over 65 you may still enroll with Part D if you have had credible coverage in the last 63 days. If no, there are other special enrollment circumstances where you can still enroll now and not wait for open enrollment in Oct. Please give us a call to discuss your specific case.
-Michelle from senior65.com


By LIN on May 21, 2018

My husband and I are both are disabled. He will turn 65 in Nov and I will turn 62. We both currently have Medicare part A and B. Husband currently has a secondary insurance carrier from his employer which covers both of us. Husband is turning 65 Nov 2018 he's eligible for a Medigap supplement policy however if he choose Medigap supplement I will loose his secondary insurance through his employer. We would like to go with the Medigap supplement because his secondary insurance pays per Medicare guidelines and we are left with alot of out of pocket deductibles and expense. Can I qualified for a Medigap supplement policy at 62 if on disability and would be loosing secondary coverage? Thank you, Lin

Lin,
The solution depends on your state. Those who have medicare under 65 and lose secondary coverage do not immediately receive guaranteed approval for Medigap based on federal guidelines. Some states, such as New Jersey, have additional rules to allow those who are on disability to be automatically approved on certain plans. Give us a call and we can see if there are options in your state.
-Eric from Senior65.com


By Phyllis on February 06, 2018

I had a state-issued Medicare Advantage policy. I canceled it because I finally found out that the company was paid to manage my Medicare and did not offer a good coverage. Since I canceled my MA plan am I guaranteed Medigap coverage.

Phyllis,
If your are in the first year of your MA plan, you can usually gain access to guaranteed Medigap coverage. If you were sold your an MA plan under fraudulent conditions that would also trigger guaranteed Medigap coverage.

There are a few more special circumstances but cancelling your plan on its own does not get make you guaranteed to be approved. Typically you would have to apply and answer health questions before you are approved. Call us to go over all your options.
-Michelle from senior65.com


By Arly on January 22, 2018

Hi, I currently have Medicare A and B and a Supplemental Medigap plan F through Gerber Insurance Co. I am considering dropping my Medigap because I am currently living in Mexico. If, I drop it and in the future, decide to return to the United States and want to re-enroll in a Medigap plan of any kind, will I be able to do this? Also, if I keep my plan, will I still be covered in the States, even though I do not reside in the State my insurance was issued in. Thank you.

Arly,
If you drop Medigap, you can always reapply for it at any time in the future. In all states but NY and CT you WILL have to go through medical underwriting when you reapply and you can be charged more or turned down. Also please check with Gerber if they will continue to cover you in the states if your residence is in Mexico.
-Michelle from Senior65.com


By Bubba on January 20, 2018

I called Medicare about the deadline for guaranteed Medigap enrollment and was clearly told it is 6 months from my 65th birthday. It turns out that it is actually 6 months from the first of the month in which I turned 65. I applied too late and had to go thru underwriting and was denied due to what I think is a misunderstanding. I am strenuously appealing the denial, as I assume that having been once denied for medical insurance (even in error), no other carrier will ever provide me any kind of medical insurance. If the appeal to the carrier fails, can you suggest any other route by which I can override the denial or obtain Medigap coverage?

Bubba,
Sorry to hear that you were given incorrect information about your deadlines. As you later learned that once you are 65, you have 6 months from your part B effective date to apply for Medigap without medical underwriting.

We have definitely helped those declined by one plan apply and get approved for another Medigap. This depends on your pre-existing condition and what state you live in. Give us a call and we can look into it.
-Amy at Senior65.com


By Grover on January 04, 2018

I am 69 and my wife is 68, both still working and have an employer's group health plan. We signed up for Medicare part A when we were 65 and Medicare Part B when I was 68 and my wife was 67 after I lost my job. I found a new job shortly afterward and we continued Part B coverage as secondary along with employer's group plan as primary. We are planning to retire in April when I am 70. Question - Can we enroll in a Medigap Plan (G or F) without medical underwriting or have we lost guaranteed issuance since Medicare B coverage has been secondary?

Grover,
Coming off work coverage typically triggers special election for Medigap Plan F where you can enroll without medical underwriting. If you want G, however, it usually requires that you answer medical questions before approval.

Some insurance carriers and states handle this situation differently so feel free to contact us to identify the right plan at the right price for your unique situation.
-Michelle from Senior65.com


By Barb on October 29, 2017

I turn 65 this November, live in CA and have Medicare Parts A & B. I also have Retiree Group Health Insurance (which includes a creditable drug plan) through my former employer.

My supplemental is a great plan, but expensive. If, in a year from now, I want to switch to Medigap Plan F & Part D coverage, would I be eligible for guaranteed issue enrollment if I voluntarily terminate my group coverage and enroll in Medigap/D? ... or does my group coverage have to be involuntarily terminated? I am currently in my initial enrollment period and trying to decide whether or make the leap now or later. I'd like to keep my current situation but will switch if there's going to be a problem with enrollment in Plan F down the road.

Barb,
The following information comes directly from the Center from Medicare Services:

"If you have group health coverage through an employer or union because either you or your spouse is currently working, you may want to wait to enroll in Part B. Employer plans often provide coverage similar to Medigap, so you don't need a Medigap policy."

"When your employer coverage ends, you'll get a chance to enroll in Part B without a late enrollment penalty. That means your Medigap open enrollment period will start when you're ready to take advantage of it. If you enrolled in Part B while you still had the employer coverage, your Medigap open enrollment period would start. Unless you bought a Medigap policy before you needed it, you’d miss your open enrollment period entirely."(source: Medicare.gov)

We have found that there are, however, many Medigap insurance companies that will approve individuals without Medical underwriting if you can show evidence of previous credible coverage. We have helped many clients outside their initial enrollment period successfully enroll in a plan by placing them with a company that honors your previous coverage.

It's a long answer that isn't so straightforward so if you have additional questions, please give us a call.
-Chris from Senior65


By Jerri on October 26, 2017

I live in NC and my age is 72. I enrolled in Medicare Part A and Part B on 03/01/2002. I have been enrolled in my husband's employer health insurance plan since 03/01/2011. If I drop his employer's insurance and enroll in a Medicare supplement of my own, will I have guaranteed issue rights?? I look forward to hearing from you. Respectfully submitted.

Jerri,
Based on the information that you have shared it looks as though most companies that offer Medicare Supplement (Medigap) plans would accept you without medical questions based on your current work-related coverage. If you give us a call we could confirm this as well as help you identify the best priced Medigap plan in your area.
-Eric from Senior65.com


By Richard on October 14, 2017

I turned 65 30 days ago, and I am currently employed. I am not signing up for Medicare A or B because I work for a large corporation, and I am covered under a qualifying employer health plan. I am currently in open enrollment and am thinking about enrolling in my company's healthcare plan for one more plan year so that I may accumulate the maximum allowable HSA deduction for one more year. If I continue working for the company and two years from now, I decide to drop their insurance coverage, at that time will I qualify for Medigap Guaranteed Enrollment period (or SEP) for Plans F or G?

Richard,
You will have up to 6 months after your part B effective date to enroll in a Medigap plan with guaranteed issue. Since you are postponing your part B start, you should be good. Please reach out to Senior65.com when you are ready to enroll.
-Michelle from Senior65.com


By Elizabeth on October 11, 2017

I live in NC and have medicare Part A & B. My age is 71. Will I have guaranteed issue rights if I terminate my coverage under my husband's employers plan and buy a medicare supplement?

Elizabeth,
Based on the information you have shared, you should be able to be approved on a Medigap plan without going through Medical Underwriting. If you need assistance, please give us a call.
-Chris from Senior65.com


By Patty on September 02, 2017

My husband and I live in Texas and currently have insurance through my employer retirement plan (TRS Care). They are changing the dropping the traditional Aetna secondary TRS plan for Medicare eligible retirees and changing to a Medicare Advantage program. We do not want Medicare Advantage. Do we have to have a letter stating the insurance coverage is changing or can we enroll elsewhere from Oct 15-Dec 7 without any limitations? My husband does have a pre-existing condition.

Patty,
This change in your work coverage should trigger a guaranteed issuance situation. Depending on which insurance company you end up with, they may require a document stating that your old coverage has ended. As far as dates, you may not have to wait until Oct 15th since it often depends on when your TRS changes. Give us a call and we can look into this for you.
-Chris from Senior65.com


By Gretchen on August 16, 2017

My husband is a retired teacher covered by TRS Humana Medicare Advantage Plan. I have been covered as well and we both have Express Scripts Rx coverage. As has been stated before, there are tremendous changes being made beginning Jan 1 and because of the high costs, I would like to drop the TRS insurance and have regular Medicare with a supplemental and a drug coverage plan. He will stay with the TRS insurance. Will I be able to do this in the open enrollment period and will I incur any penalties? Both of us have been paying Medicare premiums out of our social security checks since we turned 65.

Gretchen,
From the information you shared, you should not be subject to penalties. You should be able to enroll in both a Medigap and Part D drug plan during open enrollment (Oct 15-Dec 7) with your new coverage beginning in January. We would love to help you with this process. Helping enroll people is how we get paid. The good news is there hidden cost to you if we assist you. You are guaranteed the lowest rate allowed by law.
-Michelle from https://www.senior65.com


By A on July 27, 2017

I am 71 and have Medicare parts A and B. Up til now I was covered by my husband's employer provided retiree supplemental insurance plan and prescription drug plan. My husband is thinking of separating from me, and when he moves out, my supplemental insurance coverages will end. I believe I will need to apply for a Medigap plan, and Medicare Part D. I have health issues currently, and am concerned about the waiting period and time lapse between my application and when coverage starts. Also, do Medigap plans check pre-existing conditions in this case. I know a little about Cobra, but I don't think I can afford it, and I don't know about the coverage time gap. Thank you

A,
If you come off your husband's coverage it should trigger a special election period where you will be approved for a Medigap and part D regardless of your health history. You should not be subject to waiting periods. You can get a medigap quote here or call us and we can discuss your options.
-Chris from https://www.senior65.com


By Don on June 05, 2017

My wife and I live in Texas and currently have original Medicare Part A and Part B, and Aetna as secondary insurance through the Texas teacher retirement system (called TRS-Care). We have prescription drug coverage included through Express Scripts (which is changing to Caremark in September) as part of our TRS-Care coverage. Effective January 1, 2018, TRS-Care is requiring all participants to change to a Humana Medicare Advantage plan which includes prescription drug coverage through Silver Scripts. My wife and I wish to remain on our original Medicare and purchase a Medigap plan F policy and a Medicare prescription drug policy through USAA. Are we eligible to switch to a Medigap Plan F policy and a separate prescription drug policy without regard to pre-existing conditions effective January 1 instead of moving to the Medicare Advantage plan? We have been on our current TRS-Care insu;rance for about 3 years. This is the only plan TRS-Care is offering starting on January 1.

Don,
Great question! Since your retiree plan is being discontinued, you should have a guaranteed issuance period to enroll in Medigap Plan F. For help with this, please call one of our Senior65 licensed independent insurance agents at 800-930-7956.
-Eric from https://www.senior65.com/


By Chris on May 25, 2017

I was on my wife's qualified employer plan until age 68; however, no longer as she retired. I signed up for Medicare Part A at age 65 and Part B now at age 68. I joined an Advantage plan when employer benefits stopped. How long is the trial period if I chose to switch from the Advantage plan to Medigap without medical underwriting? I keep reading that the trial period is 12 months from when person becomes eligible for Medicare. Does the eligibility mean age 65 or when I joined the Advantage plan for the first time at age 68?

Chris,
Thank you for your question. Unfortunately, you do not have a trial right from Medicare. Here is what they have to say about your MA first year trial rights: "You joined a Medicare Advantage Plan or Programs of All-inclusive Care for the Elderly (PACE) when you were first eligible for Medicare Part A at 65, and within the first year of joining, you decide you want to switch to Original Medicare."

With that said, if you are still in your 6-month initial Medigap enrollment period from joining Part B, you may qualify to enroll without going through medical underwriting. To find out more call one of our Senior65 licensed independent insurance agents at 800-030-7956.
-Amy from https://www.senior65.com/


By robbiedt on May 05, 2017

I will be turning 65 in Jan 2017 and live in MA. I will enroll in MA's medigap plan. However, I plan to move to NJ by the end of 2017. Because Ma is one of three states that has there own plans, will I be able to switch to a medigap plan offered in NJ (ex- AARP) without undergoing a medical review? I am concerned because I do have some health issues and have read that switching plans or moving may trigger a medical review and decision whether you will be accepted as well as a decision on rate based upon your health if the plan you were currently under is not offered in the new state. Since MA has their own plans that are not transferrable, what happens to someone moving in this case? thank you

Robbiedt,
You absolutely can switch Medigap plans when you move out of Massachusetts. When you do, if you have an active Medigap policy, you should be able to enroll in any plan that is available in the state you move to without having to answer medical questions. When you move, call one of our Senior65 licensed independent insurance agents at 800-930-7956.
-Amy from https://www.senior65.com/


By Mary b. on April 28, 2017

I was taught that you have 63 days to sign up for Part D once you sign up for part B and that you have 6 months to sign up for a Supplement after Part B is activated. What I keep seeing on your answers is that you are telling folks they have 63 days to enroll in a Supplement??? That is not right according to the Medicare and You Book for 2017. It is 63 days after part B is activated for part D, and 6 months to get a supplement with guaranteed issuance after Part B is activated.

Mary b.,
Sorry for the confusion! You will have 63 days to enroll in a Medigap plan if you have certain guaranteed issuance rights (see above article for details), but if you first enroll when you first become eligible for Part B and are 65 you have a 6 month initial Medigap enrollment period. Part D, on the other hand, has a 7 month initial enrollment period (3 months before your birthday, the month of your birthday, the three months after that). For further help, please call one of our Senior65 licensed independent insurance agents at 800-930-7956.
-Amy from https://www.senior65.com/


By Joe G on January 20, 2017

I have had a real hard time trying to find answers to these: I live in Pennsylvania and will be 65 and eligible for Part B in May, 2017 and I am presently covered by my wife's insurance at work (she is an active employee, who is younger than me). 1. If I decide to retain my coverage under my wife's employee policy and decide to also add Part B (with coordination of benefits, my wife's plan pays first and Part B is secondary) can I also add a Medigap policy at that time? I know that this would not provide much, if any, benefits but I have reasons to consider doing this. 2. Would I qualify for guaranteed special enrollment in a Medigap plan (at hopefully preferred rates) if I decide to postpone electing Part B in May, but subsequently leave my wife's coverage at any time (by not signing up at annual enrollment)?

Joe,
Happy to help! Here are the answers to your questions:

1) If you retain your spouse's job-based coverage and it is considered creditable, you'll most likely want to delay Part B and NOT enroll in Medigap. As you'll be double covered, and will not even need Part B (of course you need to confirm with your wife's HR).

2) If you retain your spouse's insurance and delay Part B, you will indeed have a Medigap Special Enrollment Period when you enroll in Part B. If you were to for some reason have enrolled in Part B and retained your spouse's insurance, you will have a guaranteed issuance period into only a handful of plans (does not include Plan G).

For help enrolling in a Medigap plan, call one of our Senior65 licensed independent insurance agents at 800-930-7956.
-Amy from https://www.senior65.com/


By Jan on December 02, 2016

My husband turns 65 on May 16, 2017. His current health plan has been discontinued as of 12/31/16. Is it possible to enroll in Medicare early?

Jan,
Unless he's on disability, no, he cannot join Medicare early. However, he can enroll in an ACA plan. We can help with that and, if he decides, Medigap or Medicare Advantage, when the time is right. Call one of our Senior65 licensed independent insurance agents at 800-930-7956.
-Chris from https://www.senior65.com/


By Rick Torrez on November 18, 2016

I am 67, still working and have an employer's group health plan. I signed up for Medicare part A at 65. My wife is 62 and a retired postal employee with retiree group health insurance from the Postal Service. When I retire next year I would like to join her policy as a spouse and not sign up for Medicare parts B and D. If she were to pass away I would lose my coverage under her plan. Would I then be able to sign up for Medicare parts B and D with out penalty and to a Medigap plan under guaranteed enrollment without a questionnaire?

Rick,
If you were to join your wife's retiree benefit plan and she were to pass away, you will be able to enroll in Medicare Parts B and D, as well as Medigap, with a Special Enrollment Period. You will not owe a penalty or have to answer medical questions.
-Amy from https://www.senior65.com/


By Sharon on November 09, 2016

My husband and I are over age 65 and have medicare part A and B. We also have insurance from my former employee (City), which does not require us to have medicare. We now want to opt out of the City's insurance and get medigap insurance. This would be voluntary loss of medical coverage. Do we qualify for guarantee enrollment.

Sharon,
It will depend if your job-based insurance was considered creditable coverage. If it was, and it is ending, you should have a guaranteed enrollment period that allow you to enroll in a handful of plans without answering medical questions (not all plans are available without underwriting, since you didn't delay Part B). If it is not considered creditable coverage, you will need to go through medical underwriting to apply to all Medigap plans. If you need help finding a Medigap plan in your area call one of our Senior65 licensed independent insurance agents at 800-930-7956.
-Amy from https://www.senior65.com/


By CHUCK HUNT on October 06, 2016

I will leave active employment at age 67. I did not sign for Part B at age 65 because I am covered under a qualifying employer health plan while working, but will not be under any employer retiree plan. If I am correct, I will be under a Medicare Special Enrollment Period upon retirement, and will be in the Medigap Guaranteed Enrollment period for most Medigap plans. However, I am confused as to whether I will be eligible for Plan G (without qualification requirements or premium "adders"). Please clarify.

If you delayed Part B and have creditable coverage, once you enroll in Part B it should trigger your Medicare Supplement initial enrollment period which lets you enroll in any plan sold in your state, including Medigap Plan G. When you're ready to enroll, call one of our Senior65 licensed independent insurance agents at 800-930-7956.
-Amy from https://www.senior65.com/


By Michael on October 06, 2016

Under the Medicare website explaining the Guaranteed issue rights, it says that I can get any Medigap policy that is sold in my state by any insurance company and that I can do that as early as 60 calendar days before the date coverage will end, but no later than 63 calendar days after your coverage ends. It also adds a NOTE that says your rights to a Medigap policy may last for an extra 12 months under certain circumstances though can't get an answer as to what those certain circumstances are, including calling Medicare. Do you know what those certain circumstances are?

Michael,
Special circumstances are varied by case, and that is why is there is not a specific rule that applies here. If you believe you have a special circumstance, you would want to contact CMS directly. If you are ready to enroll in a Medigap plan, you can contact us by calling 800-930-7956.
-Eric from https://www.senior65.com/


By Steve on September 22, 2016

I have a friend who is on Medicare and has a company sponsored Medicare Advantage Plan through her husband's previous employer. Her husband passed away and they are allowing her stay on the plan but are charging her a premium whereas it was no cost when her husband was alive. Does this qualify her for a special guaranteed enrollment period for a Medigap plan? If so what is her time frame to select a plan?

Steve,
If she chooses to leave her late husband's employee sponsored plan, it should give her guaranteed issuance to a Medigap plan. Generally, she has 63 days to enroll in a plan, and she has a limited selection of plans. If she needs help finding a Medigap plan in her area, please have her call one of our Senior65 licensed independent insurance agents at 800-930-7956.
-Chris from https://www.senior65.com/


By Claudia Gray on August 03, 2016

My brother has Medicare A and B, a Medigap Plan and Medicare D. He is 67. He is going back to work full time. His employer offers a Health Plan. He needs to get on the health Plan as his wife is only 60 and needs insurance. What will happen if he drops his Medigap Plan, then wants to re-enroll when he stops working, again? Thank you!

Claudia,
According to CMS' guaranteed issue right #2, he should be able to re-enroll:

"You have Original Medicare and an employer group health plan (including retiree or COBRA coverage) or union coverage that pays after Medicare pays and that plan is ending. You have the right to buy Medigap Plan A, B, C, F, K, or L that is sold in your state by any insurance company."

When he's ready to rejoin a Medigap plan, please call one of our licensed independent insurance agents at 800-930-7956.
-Amy from https://www.senior65.com/


By Kiva on April 11, 2016

Had a patient that lost her Medigap plan due to late payment missing the grace period by 2 days. She is now Medicare only and was hoping to take a chance to enroll in another supplement since her appeal was denied twice to enroll again in the Medigap Plan she had. Is this possible or at least worth trying for her. She is a long way from 65 years old. Thanks.

Kiva,
Absolutely, she can apply. She will most likely to have to undergo medical underwriting, unless she lives in a state that offers Medigap guaranteed issuance. To apply for a Medigap plan, call one of our licensed independent insurance agents at 800-930-7956.
-Eric from https://www.senior65.com/


By Samuel L. Statland on January 05, 2016

Amy, What States off Guaranteed issue Medigap Supplement plans without a pre-existing clause. Is one available in MD?

Samuel,
All states have Medigap guaranteed issuance during your initial enrollment period, and if you have a qualifying event. If you are looking for states that have Medicare Supplement guaranteed issuance at any time outside of those periods, there are only a handful like New York and Connecticut. Unfortunately, Maryland is not one.
. -Amy from https://www.senior65.com/


By Sharon on November 30, 2015

My spouse and I are currently covered with Medicare A &B and at 65 kept my employers plan that was offered called the Medicare Indemnity plan .The premium has become quite expensive and has a deductible.Can I opt out of my employers plan and apply for a Medigap plan? Would this be under the Medigap Special Enrollment? Thank you

Sharon,
You should be eligible for a Medicare Supplement Special Enrollment Period. Please call us at 800-930-7956, and we'd be happy to help you find the right plan.
-Michelle from https://www.senior65.com/


By Pam on November 20, 2015

I am 66 and will turn 67 in March. I have Medicare A and B but never enrolled in a medigap or Medicare Advantage plan but wish to do so now. Yes, I blew it. Since I have never had either one, can I enroll anytime in the year or must it be during this fall period? Also,I have been told 2 different things by 2 brokers. One said I have to sign up with Plan F first, then I could switch later and also that I can switch only once in my lifetime. The other broker said not true. Since I likely will have to submit to a health screening and answer health questions (I have no major health issues), would I more easily qualify for a Medicare Advantage plan vs a medigap plan first?

Pam,
You didn't blow it! We have plenty of clients that are approved after their initial enrollment period. As for switching, in most states, you'll have to answer medical questions to switch to any Medigap plan, regardless of whether it's the same letter plan or even if it's within the same company.

Since you have no major health issues, you may be approved for Medigap, and should apply now. As for Medicare Advantage, you will always be approved (unless you have ESRD). Remember, you can always leave Medigap for Medicare Advantage, but not the other way around, so better off to get started with Medigap, if you're approved.
-Amy from https://www.senior65.com/


By Margaret Leet on October 09, 2015

My husband is 68 and is covered under Humana Advantage plan (was originally just Medicare); however, we have found since he enrolled that no one in our immediate area takes the plan. I am covered under Medicare (age 66) with a medigap plan F with BCBS in Georgia (Barrow County). I was able to keep my doctors. He would like to switch back to Medicare and get on the BCBS F plan hoping for a family plan. I have my RX costs deducted from my social security and he would like to do that too. Is this possible?

Margaret,
We definitely understand the concern over the Medicare Advantage limited network. As for Medigap, your husband can definitely apply (he'll probably need to undergo medical underwriting) and choose a separate prescription drug plan. Let us know if you need any help: 800-930-7956.
-Jacima from https://www.senior65.com/


By Marla Spellman on August 29, 2015

I am 65 and I am covered by my husband's employer's group plan. I signed up only for Medicare A. However, I want to sign up for Part B and a Medigap plan for Jan. 1 of 2016 because his insurance ends Dec.31. Will the Medigap special enrollment period apply to me?

Marla,
If you are enrolled as a spouse with qualifying insurance you should be offered guaranteed enrollment. This type of enrollment period limits the plans you can enroll in (only A, B, C, F, K, or L), without having to answer medical questions. However, if you are still within the first 6 months of turning 65, you can enroll in any Medigap plan without answering medical questions. Hope this helps.
-Amy from https://www.senior65.com/


By Josh on May 21, 2015

This is good. I qualify under #4! Which is good because I was just diagnosed with a heart condition.


By penelope quinn on May 12, 2015

wow. good info. want to make sure i undersand, if i get a medicare advantge plan but i decide i don't like in my first year of enrollment i can enroll "guaranteed" into a medigap plan?

Penelope,
Great question! You have a guaranteed enrollment period for a Medigap plan if you were enrolled in an MA plan ONLY within your first year of being Medicare eligible. Hope this explained it better.
-Jacima from https://www.senior65.com/



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