What You Should Know About Medicare Open Enrollment
Medicare is an incredible benefit to many Americans, especially those age 65 or older. While it provides people with assistance in accessing various types of medical care they might not otherwise be able to afford, Medicare is not a perfect solution.
What you may not know is that Medicare Supplement Insurance exists. Sometimes known by the name Medigap, this insurance does exactly that; Medicare supplement insurance helps cover some of the gaps in traditional Medicare coverage. (1)
There are some things you need to know about Medigap, however, otherwise, you may miss out on using this supplemental insurance to its fullest effect.
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How Do I Qualify?
As a rule, if you are covered by Medicare you’re usually eligible for Medigap. As always, though, there are some exceptions.
For example, if you are covered by Medicare but have not yet reached 65 years of age, your state may not offer Medigap Insurance. While Medicare supplemental insurance is required by Federal law to be offered by states to those 65 and older, there is no such requirement for those covered by Medicare under the age of 65.
Don’t lose hope if this describes you; some states do have limited Medigap plans for younger Medicare recipients with specific conditions. These options vary from state to state, so you will have to check with your specific state of residence to find out what if any Medigap plans are available.
If you are 65 or older and are covered by Medicare, your ease of getting Medicare supplemental insurance can change depending on when you first apply for it.
The Medicare Supplement Open Enrollment Period
Once you’re 65 or older and enroll in Medicare Part B, your Medigap open enrollment period begins. Specifically, the first day of the first month that you are both 65 or older and enrolled in Medicare part B is the start of your six-month open enrollment window.
During your open enrollment period, you have what is known as “guaranteed issue”. This means that, during this six months, insurance companies cannot deny you enrollment into a Medicare supplement insurance plan for any reason.
Preexisting conditions, medical history or other factors that insurance companies usually use to determine eligibility and cost of insurance plans are, by law, not allowed to be taken into consideration by insurance companies during this time.
Depending on your personal situation and the offerings available in your state, your open enrollment period may be your best chance to jump into a Medicare supplement insurance plan. However, just because you missed this open enrollment window doesn’t mean you have missed the opportunity to enroll completely, but after open enrollment has passed you may find it more difficult. (2)
I Missed Open Enrollment…Now What?
First, don’t panic. There are still Medigap Insurance options available to you; in fact, many of the same options may still be open that were available during open enrollment. The difference will be that you may find it more difficult to find coverage.
If you have any disabilities or any serious pre-existing conditions, insurance companies can use this as a reason to deny you Medigap Insurance coverage once your open enrollment period has ended. In fact, any health problems can be used as a justification to deny coverage at this point.
Another factor is cost; during open enrollment, insurance companies are not allowed to consider any preexisting conditions or health problems you have when determining the cost of your supplemental insurance. Once that six month period has passed, companies are free to use their traditional methods of determining your suitability for coverage…and the amount of your premium.
Unfortunately, if you missed your open enrollment period, you may very well be facing higher premiums for any supplemental insurance you do qualify for.
Whether your Medicare coverage has been going on for a while or is still in your future, now is the time to find out what your options are. Medicare supplemental insurance can save you thousands of dollars in the long run, so don’t let your open enrollment period pass you by.
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