Harry Truman lobbied for it for 20 years; Medicare was established in 1965, and in 1966 The Aetna Life Insurance Company offered the first Medicare Supplement plan. “Medigap” plans or Supplements help “cover the gap” of the copays, deductibles, and the 20% that’s not covered by Medicare. This is why people get Medicare Supplements.
Are you “New to Part B”? Yay, the Medicare Supplement companies won’t be checking out your medical history to underwrite your policy. You’re getting the best rate by your local companies – even if you’ve survived cancer or have had several joint replacements.
Why Should I Get a Medicare Supplement?
Medicare Supplement plans offer the most freedom, medically speaking. You can go to any physician or medical facility that accepts Medicare in the U.S. This allows you to hit the road! Or jet off to another state to visit the grandkids and not have to worry about being in a network. It allows you to see various providers in any random set of networks without worrying about referrals – doctors just love Medicare Supplements! Most important, if you have a serious medical condition, you can go for treatment to Cedars-Sinai in California or MD Anderson in Texas and be accepted.
How A Medigap Plan Works
It was an Act of Congress . . . .
Did you turn 65 after January 1, 2020? Sorry, Congress won’t let your insurance cover the Part B deductible, so you can’t get a Plan C or F. But if you already had Plan C or Plan F before January 1, 2020, you can keep your plan. And if you turned 65 before January 1, 2020, but didn’t enroll, you could still get a Plan C or F.
Available Medicare Supplement Plans (plans vary by state)
According to Medicare.gov, insurance companies that sell Medicare Supplement or Medigap plans:
• Don’t have to offer every Medigap plan
• Must offer Medigap Plan A if they offer any Medigap policy
• Must also offer Plan C or Plan F if they offer any plan
They Say It’s Your Birthday!
Does your state have a Medicare Supplement Birthday Rule? If your state is California, Delaware, Idaho, Illinois, Kentucky, Louisiana, Maryland, Massachusetts, Missouri, Nevada, Oklahoma, Oregon, Utah, Virginia, West Virginia, or Wyoming, you have more options regarding your Medicare Supplement/Medigap plan. This is one time during the year that you can change your plan (and depending on your state, your carrier), and not have to answer health questions. No health questions means you get the best possible premium for your age and location! It’s Guaranteed Issue.
In California, if you want to move from your current Medicare Supplement plan, you can! You can apply starting on your birthday and 60 days after your birthday! Yes, you can move to any plan of equal or lesser benefit with the carrier of your choice. The soonest your new plan can take effect is the month after your birthday.
Now in Delaware, you can change to a plan of equal or lesser value 30 days prior to and no later than 30 days after your birthday.
Idaho lets you sign your application on your birthday and up to 63 days after your birthday. The plan benefits must be of equal or lesser value than your current plan.
Illinois is more strict about their Birthday Rule; your new plan benefit must not exceed your current plan, AND you have to stay with the same company. Your special enrollment window starts on your birthday and lasts for 45 days. Get crackin’!
In Kentucky, you can enroll on your birthday and up to 60 days after. You must choose the same plan as your current plan, though, F to F, or G to G, etc..
The Louisiana supplement purchase must be on your birthday and up to 63 days after. You can switch to a plan of equal or lesser benefits, but only to the same company or any affiliate.
Maryland has a shorter enrollment window, you can sign up to 30 days following your birthday. You may switch to a different Medicare Supplement policy with equal or lesser benefits than your current one.
Massachusetts is an outlier: There is a two-month window from February to March every year.
Missouri is another outlier – no birthday rule, but an anniversary rule! You have an annual chance to change from one Medicare Supplement carrier to another without any underwriting, but it must be plan-to-like-plan only. Your chance starts 30 days before your enrollment anniversary date and 30 days after.
For Nevada, you can change your Medigap carrier or plan to an equal or lesser one on the first day of your birth month, and the window to change is open for 61 days after your birthday.
In Oklahoma you a 60-day open enrollment beginning on your birthday. Your new plan must have the same or lesser benefits, with the same or a different carrier
Oregon also allows policyholders to change to a plan with any carrier of equal or lesser benefit without health underwriting. You could change 30 days before your birthday or 30 days after, giving you 61 days to take advantage of the rule.
Utah allows a 60-day enrollment period, beginning on your birthday. You must stay with your same carrier, but can switch to a comparable or lower tier plan offered by them.
Yes, Virginia, you have a Birthday Rule! It’s 60 days beginning on your birthday, to the same plan, but to any carrier.
In West Virginia, you now can switch on your birthday and up to 60 days after to a plan with equal or lesser benefits, but with your same carrier or an affiliated company.
Wyoming has joined the Birthday Rule party; you have a 63-day enrollment period, beginning on your birthday, for similar or lesser benefits issued by any carrier.
Not Your Birthday, Even BETTER: Year-Round GI Rules!
In Connecticut, Maine, Washington State, and New York, you can change your Medicare Supplement to one you like better AT ANY TIME, Guaranteed Issue! But pay attention, your state may have its own little quirks.
Connecticut has no underwriting at any time for Medicare Supplements. This means those on a Medicare Supplement can move to any other Medicare Supplement at any time without answering health questions.
In Maine, there is no underwriting required at any time to switch to a Medicare Supplement of same or lesser benefits. Maine does have a one-month Open Enrollment for Plan A each June.
In the state of Washington, there is no underwriting required at any time to switch from one Medicare Supplement to another, except for moving from a Plan A. Beneficiaries can only move from Plan A to another Plan A.
Start Spreading the News: There is no underwriting at any time for Medicare Supplements in New York state. This means those on a Medicare Supplement can move to any other Medicare Supplement at any time without answering health questions.
Want to check out some Medicare Supplement rates? Use this quick tool; results open into a new tab. (Some of the rates may feature household discounts – be sure to talk to me about that.)
Required Disclaimer: “We do not offer every plan available in your area. Currently we represent 0 to 28 organizations that offer 0 to 28 or more products in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.” So there.
