Many Medicare beneficiaries who already are covered by a Medicare Supplement (aka Medigap) plan, such as Plan F or N, often incorrectly think they can make changes to their health plan only once a year―during the Annual Election Period (AEP), which falls between October 15th and December 7th.
Not true. If you currently have a Medigap plan, you can apply for another plan with the same insurer or with a different one at any time of the year. But, you should know the guidelines:
- When you decide to apply for a new Medigap plan, you’ll likely undergo medical underwriting―you’ll need to answer questions about your current health and medical history.
- Depending on the insurer’s underwriting criteria, your request for new coverage might be denied because of your medical history or specific conditions.
- Some insurers do accept applicants who have one or more medical conditions. In this case, the insurer can charge the applicant an adjusted (higher) premium.
If you want to convert your Medigap plan to a Medicare Advantage plan―an HMO or PPO with Part D prescription drug coverage―you can make this change only during AEP (Oct. 15 – Dec. 7). Your new Medicare Advantage plan will then be effective on January 1 of the following year.
When you change from a Medigap plan to a Medicare Advantage plan, you must cancel your Medigap plan, effective the date your new plan becomes effective. Otherwise, you’ll have duplicate coverage and your claims will not be processed.
Other Rights: Guaranteed Issue and Trial Right.
Beneficiaries whose Medigap plan is withdrawn from the service area by the insurer are allowed to purchase a new Medigap plan without the need to undergo medical underwriting.
Medicare also gives beneficiaries who voluntarily leave a Medigap plan to enroll in a Medicare Advantage plan for the first time a Trial Right―that is, if at any time during the first year on the Medicare Advantage plan beneficiaries want to return to your Medigap plan, they can.
Specific rules apply, however, for both Guaranteed Issue and Trial Right purchases. Before making changes, beneficiaries should call their Broker of Record or visit www.medicare.gov.