Is there a best time to enroll in a Medicare supplement plan?

  • By
  • Contributor
  • February 28, 2015

Q: Is there a best time to enroll in a Medicare supplement plan?

A: Yes. The best time to enroll is during your Medigap open enrollment period, a six-month window of time that begins on the first day of the month that you are aged 65 and are enrolled in Medicare Parts A and B.

During this period, a private insurance company that offers Medigap coverage can not:

  • refuse to sell you any Medigap policy it offers
  • make you wait for your coverage to take effect (except under certain circumstances); or
  • charge you additional fees for your coverage because of your medical history.

A private Medigap insurer may refuse to repay your out-of-pocket expenses if you have a pre-existing health issue. If your pre-existing condition was diagnosed or treated within six months prior to the date your Medigap supplemental coverage was to begin, the insurance company can make you wait six months before covering your out-of-pocket expenses. The rules can be confusing, so don’t hesitate to talk to a representative of the Medigap private insurance company for clarification.

After your six-month open enrollment window, Medigap plans are medically underwritten, meaning that if you apply for coverage outside of your open enrollment window, you can be declined or charged more based on your medical history.  There are also some limited special enrollment periods for Medigap coverage, including

  • moving out of your plan’s service area
  • losing a group or retiree plan that has been paying secondary to Medicare
  • the Medigap or Medicare Advantage plan you’re on leaves Medicare or stops offering coverage in your area, or you leave the plan because they didn’t follow Medicare’s rules.
  • you’re in a Medicare Advantage plan and are utilizing your “trial right” to switch back to Original Medicare
  • you didn’t enroll in Medicare when you were first eligible at age 65, and you’re enrolling in Medicare Parts A and B during general open enrollment – you’ll have a six month special enrollment period for Medigap plans at that point.