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How do I know if I’m eligible for a Medicare supplement (Medigap) plan?

May 14, 2020

Reviewed by our health policy panel.

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Q: How do I know if I’m eligible for a Medicare supplement (Medigap) plan?

A: You are eligible for Medicare supplement (Medigap) coverage if you are already enrolled in Medicare Part A and Medicare Part B. The open enrollment window is six months long, beginning on the date your Medicare B becomes effective.

During this six-month window, Medigap carriers must allow you to enroll in any plan you choose, and cannot charge you more based on medical history. After your open enrollment window is over, medical underwriting can be used if you apply for a Medigap plan (unless you qualify for a special enrollment period, which is limited to certain plans in some cases).

Can I enroll in Medigap if I'm under age 65?

Federal regulations regarding Medigap open enrollment do not extend to Medicare beneficiaries who are under 65. But most states will allow you to purchase a Medicare supplement plan even if you are not 65, as long as you’re enrolled in Medicare (because you’re disabled or have end state renal disease, for example).

There are 33 states that require Medigap insurers to allow any newly-eligible Medicare beneficiary to purchase at least one type of Medigap coverage, but in most cases, the insurers can charge additional premiums for people who are under 65. (Since these beneficiaries are disabled, their health costs tend to be high, which is why Medigap carriers shy away from offering coverage to people under 65, unless required to do so by state law.) For details about the regulations in your state, you can click on your state on this map, or contact your state Insurance Commissioner.

If you are enrolled in Medicare before turning 65 because of a disability, you’ll have a six-month window during which Medigap plans will be available with no medical underwriting following your 65th birthday. For some beneficiaries, this can mean a considerable drop in premium for Medigap coverage, due to the lower prices that often apply to people who are age 65.

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Elaine
2 years ago

I have Medicaid. Will they help pay for my Part b?

Admin
2 years ago
Reply to  Elaine

Elaine, this article explains how beneficiaries can get help paying for Medicare premiums.
https://www.medicareresources.org/faqs/is-there-help-for-me-if-i-cant-afford-medicares-premiums/

Hope that helps.

Toshua
1 year ago

I’m 51yo on ssdi can I apply for a Medigap plan

Editor
1 year ago
Reply to  Toshua

It depends on where you live. Here’s a state-by-state summary of how Medigap eligibility works for people who are under age 65: https://www.medicareresources.org/medicare-eligibility-and-enrollment/medigap-eligibility-for-americans-under-age-65-varies-by-state/
You’ll also want to contact the Medicare SHIP in your state, as they’ll be able to provide state-specific advice: https://www.seniorsresourceguide.com/directories/National/SHIP/

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