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May 19, 2011

Changing Medicare Supplement Insurance (Medigap) Plans

Paying for Medigap benefits you don't use? Need more Medigap benefits than you have? Looking to save money on your Medigap premium? These are great reasons for changing Medigap plans. It's not always possible, but it can be done.

If you're changing Medicare Supplement plans because you need better benefits - for example, you're not as healthy as you were when you first bought the policy - an insurer can deny you coverage or charge you a higher premium. Some states and insurance companies do offer guaranteed-issue plans after open enrollment, but you'll have to do some homework to see if changing Medicare Supplement plans is even possible.

With certain exceptions, you are only guaranteed the right under Federal law to buy any of the Medigap plan designs offered during your open enrollment period. This period begins the first month you are age 65 or older and you have Medicare Part B.

Exceptions for guaranteed issue when switching Medigap plans include:

  • Your Medigap insurance company has left your service area
  • You move out of your Medigap plan's service area
  • You switch Medigap plans within the six months of your Medicare Open Enrollment Period

Note: If you have an older Medigap policy that is no longer available, even if it includes coverage for prescription drug expenses, you may keep the plan. None of the Medigap plan designs offered today include prescription drug coverage, so switching Medigap plans could cause you to lose that coverage.

Free-Look Period

When switching Medigap plans, do not cancel your old policy until after your new policy is in effect. You are allowed to carry both policies for a period of two in order to decide if you are satisfied with your new choice. On the application, you must promise to cancel the other policy within two. The period is not truly "free" since you have to pay the premium for both plans during that time.

Switching from your Medicare Advantage Plan to Original Medicare plus Medigap

You have a right under Federal law to guaranteed-issue Medigap when changing from a Medicare Advantage Plan (Medicare Part C) to Original Medicare plus Medigap under these conditions:

  • You chose to delay your enrollment or cancel your automatic enrollment in Medicare Plan B during your Medicare initial enrollment period and you have since signed up for a Medicare Advantage Plan; and you have never had Medicare Part B, nor have you had a lapse in medical coverage
  • You switched from Original Medicare plus Medigap to a Medicare Advantage Plan, and then, within one year, you decide to switch back to Original Medicare plus Medigap, but the plan you were in previously is no longer available

Some insurers and states have other provisions that may allow guaranteed issue for switching Medicare Supplement plans. Check the insurer's or your state's insurance websites to find out what their rules for enrollment include.

Note: Medigap policies do not cover out-of-pocket costs for Medicare Advantage Plans. If you already have a Medigap plan with Original Medicare, and you decide to change to a Medicare Advantage Plan, you should drop your Medigap plan. But you do have the legal right to keep the policy if you think you might want to return to Original Medicare someday. That might be one way to guarantee to keep the Medigap policy you want. Keep in mind, however, that you'll continue to pay a Medigap premium for a policy you won't be able to use.

* By submitting this form, you agree that a licensed sales rep may contact you to discuss the specific types of products listed above. The sales agent that will be discussing plan options with you is either employed or contracted by a Medicare Health plan or prescription drug plan that is not the Federal government, and they may be compensated based on your enrollment in a plan. Submitting this form does NOT affect your current enrollment, nor will it enroll you in a Medicare Advantage plan, Prescription Drug Plan, or other Medicare plan. A Medicare Advantage plan is a health insurance plan provided through a private insurer and delivers Medicare Part A and Part B benefits. A Part D Drug plan is a prescription drug insurance plan provided through a private insurer and delivering Medicare Part D benefits. A Medicare Supplement plan is a health insurance plan provided by a private company that fills in the "gaps" in original Medicare coverage. By submitting this form, you acknowledge that you have read and understand PlanPrescriber's Terms and Conditions.