Medigap has two types of enrollments that do not require you to answer medical questions. These periods of time are called a few different names, which can be confusing. Let us break it down for you, so that understand the different terms and their rules.

This article was written on May 19, 2015 and was updated on the date above.

Medigap Open Enrollment

We choose to call Medigap’s Open Enrollment period your, “initial enrollment.” The reason we call it your “initial enrollment” is many people confuse the term “Medigap Open Enrollment” with the “Medicare Open Enrollment” period.

Open Enrollment Medicare allows someone to change their Medicare drug or Medicare Advantage plan each year. It is NOT a guaranteed-issue period for Medigap in most states.

Looking for more information about Medicare Open Enrollment? Click the button below.

Learn More about Open Enrollment

Medigap Open Enrollment generally only allows you ONE guaranteed enrollment period*, regardless of preexisting conditions**. This 6-month period begins the first month you are both 65 or older and enrolled in Medicare Part B. This usually happens in one of two situations: 1) You turn 65 and start Part B, or 2) You delayed Part B because of active employer coverage and start Part B when that coverage ends. At this time, you can enroll in any Medigap plan sold in your state. (Source: Medicare.gov)

*In some states, if you have a current Medigap plan, you can switch without medical underwriting – such as the Medigap Birthday Rule states, including California.

**Medigap plans may charge more for smokers. May is the operative word. Not all providers or states charge more. As well as, if you sign up right at 65 or during Medigap’s initial enrollment period, you may bypass this additional premium. Click on the button below to compare Medigap plan providers in your state.

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Medigap Guaranteed Issuance Period

The Medigap Guaranteed Issuance Period is generally a 63-day period after your qualifying event (in many situations you can also apply up to 60 days before your current coverage ends). This period is also called your Special Enrollment Period. At this time, you have certain rights to enroll in a new Medigap plan without having to answer medical questions, as well as an insurance company cannot apply a preexisting waiting period. Here are some of the circumstances that qualify you:

  • Your Medicare Advantage plan leaves Medicare or stops providing care in your area
  • You move out of your Medicare Advantage plan’s service area (or out of a Medigap SELECT policy’s area)
  • Your employer or union group health plan that pays after Medicare is ending
  • Your Medigap insurance company goes bankrupt, or your Medigap or Medicare Advantage plan misled you or didn’t follow the rules
  • Medicare Advantage Trial Period (your first 12 months in Medicare Advantage)

Read the article Medigap: 7 Ways to Qualify for Guaranteed Issuance to learn more about guaranteed issuance and open enrollment periods.

Want to know if you’ll be approved before applying for a new Medigap policy? Our Medigap Underwriting Checker Chatbot gives you that insight—and saves you from unnecessary applications.

Medigap Plans Not Qualified for Guaranteed Issue

In most federal guaranteed-issue situations, you are only guaranteed Plans A, B, C, F, K, or L (or Plans A, B, D, G, K, or L if you were new to Medicare on or after January 1, 2020). Plans like M and N are NOT guaranteed during a Guaranteed Issuance Period/Special Enrollment Period (they are allowed during your initial/open enrollment) and will usually require you to answer medical questions. One exception: if you joined Medicare Advantage when you were first eligible at 65 and leave within the first year, you can buy any Medigap plan sold in your state. Some states also offer broader rights.

Conclusion
As you can see, Medigap enrollment has very specific time frames and rules, that you’ll want to adhere to in order enroll in the best plan for you. For further questions call 800-930-7956 or click here to get a Medigap quote.