Medicare Supplemental insurance plans are a type of health insurance policy that covers the 20% of health care expenses that Medicare doesn’t.
A Medicare Supplement insurance policy may offer you peace of mind in knowing there’s no gap in your health coverage.
About Medicare Supplemental Insurance
Original Medicare still requires you to pay for some things, like 20% of outpatient expenses. That’s why supplemental policies were created to bridge the gap in coverage.
Some of the primary advantages of a traditional Medicare supplement policy are:
- Ability to choose your own doctors and hospitals
- No referrals required to see a specialist
- Plan F: for any Medicare-covered services
- Nationwide coverage
Supplemental insurance for Medicare is the most predictable back-end coverage.
What is the open enrollment period for Medicare supplemental plans?
When people first enroll in Medicare Part B, they have 6 months to enroll in any Medicare supplement without answering health questions. This time frame is the Open Enrollment Period and it’s a one-time window to pick a plan. The insurance company will approve your application with no pre-existing condition waiting period.
You cannot get a Medicare Supplemental Insurance plan during the Annual Election Period (AEP). During this period, you can only add/drop Medicare Advantage plans or Part D prescription drug plans.
Can you change Medicare supplements anytime?
You can apply to change your Medicare Supplement at any time, but if you are past your open enrollment period, you will likely have to answer health-related questions. Based on your health and medication history, the Medicare supplement company can choose to accept or deny you.
There are a few states where the rules are different. For example, California, Oregon, Connecticut, and Washington have established exceptions to this rule. Make sure you check to see what your state says about changing Medigap plans.
In certain circumstances, you can add a Medigap plan without answering health questions. For example, if you gain or lose Medicaid eligibility, you have a short window to apply for Medigap without health questions.
Another example would be for someone coming off employer health coverage that is primary to Medicare. They will have a short window to apply for certain Medigap plans under guaranteed issue rules.
Do you have to have Medigap?
No, it is completely optional. However, if you don’t have supplemental insurance, you will have to pay deductibles and copays as well as 20% of the cost of ALL outpatients services. This includes things like surgeries and chemotherapy which would be financially devastating without some form of supplemental coverage.
As an alternative to Medigap, you might consider a Medicare Advantage plan, which has lower premiums. The reason Medicare Advantage is cheaper is that you are restricted to using a network of local providers.