Q: Does all Medicare private coverage have open enrollment periods?
A: No, it doesn’t – and it’s important to know the difference before you enroll:
For Medicare Advantage and Medicare Part D, there’s an annual open enrollment period (October 15 to December 7). During this time, you can switch to any other Medicare Advantage or Part D plan available in your area, regardless of your medical history. (One caveat: if you’re on a Medicare Advantage plan and you’re diagnosed with end-stage renal disease, you’ll be limited to Medicare Advantage plans offered by your current carrier, unless your carrier stops offering plans in your area.)
But there’s no annual open enrollment period for Medigap (Medicare Supplement) plans. You can apply for a Medigap plan anytime, but after your initial six-month enrollment window has passed, the carrier can use your medical history to determine your eligibility and premium. However, states can impose their own regulations for Medigap plans; in New York and Connecticut, Medigap plans are not medically underwritten, regardless of when an applicant enrolls. If you have questions, check with your state SHIP or your state’s Division of Insurance for more information.
If you’re in good health, you’ll be able to switch to a different Medigap plan, but some Medigap plans are priced based on the enrollee’s age when the plan is issued, so they’ll be more expensive if you enroll later, even if you’re healthy.
There are some limited special enrollment periods during which you have access to all or some Medigap plans with no medical underwriting. (See page 10-11.) These include circumstances where your old Medigap plan is no longer available (if you moved out of the plan area, or the carrier stopped offering the plan, for example), the carrier didn’t follow the rules, or you’re in your one-year “trial period” after selecting or switching to Medicare Advantage and you want to go back to Original Medicare and a Medigap plan.
So while Medicare Advantage and Part D plans have annual open enrollment periods during which all plans are guaranteed-issue, the same is not true for Medigap plans. This is part of the reason many Medigap enrollees choose comprehensive plans despite higher premiums.
Plan F is the most comprehensive option. In 2014, 56 percent of Medigap enrollees were enrolled in Plan F, including the high-deductible version of Plan F. The next most popular choice -Plan C – garnering just 10 percent of enrollees.