Can I switch my Medigap plan later?
Yes, you can switch your Medigap (Medicare Supplement Insurance) plan later, but there are certain rules and potential limitations depending on when and why you want to switch. While you can change plans at any time of the year, your ability to switch without medical underwriting (where an insurer can deny coverage or charge higher premiums based on your health) may be restricted. Here’s what you need to know about switching Medigap plans:
1. Switching During Your Medigap Open Enrollment Period
The best time to switch or purchase a new Medigap policy is during your Medigap Open Enrollment Period, which starts when you are both:
65 or older.
Enrolled in Medicare Part B.
This six-month period offers guaranteed issue rights, meaning insurance companies cannot deny you coverage or charge you higher premiums based on your health. During this period, you can switch Medigap plans as many times as you like without medical underwriting.
2. Switching After the Medigap Open Enrollment Period
After your Medigap Open Enrollment Period ends, you can still switch Medigap plans, but you may face some challenges:
Medical Underwriting: Most insurance companies can require you to undergo medical underwriting if you apply to switch Medigap plans after your Open Enrollment Period. This means they can:
Deny coverage based on pre-existing health conditions.
Charge you higher premiums based on your health history or age.
Exceptions: Some states have special rules or protections that may allow you to switch plans without medical underwriting. For example, certain states offer annual Medigap open enrollment periods or have laws that guarantee access to specific Medigap plans.
3. Switching with Guaranteed Issue Rights
There are specific situations in which you have guaranteed issue rights to switch Medigap plans without medical underwriting, even after your Medigap Open Enrollment Period has ended. These situations include:
Losing other health coverage: If you lose Medicare Advantage or another form of health coverage (e.g., your Medicare Advantage plan stops serving your area, or you move out of the plan’s service area), you have a guaranteed right to buy certain Medigap plans.
Switching from Medicare Advantage: If you leave your Medicare Advantage (Part C) plan and return to Original Medicare within the first 12 months of your first enrollment in Medicare Advantage, you can switch to a Medigap plan with guaranteed issue rights.
Your Medigap insurer goes out of business: If your Medigap insurance company goes bankrupt or misleads you, you have guaranteed issue rights to purchase a new plan.
Trial Rights: If you dropped a Medigap policy to try a Medicare Advantage plan and later decide you want to return to Medigap (within the first 12 months), you have a guaranteed right to switch back to your previous Medigap plan or a similar plan.
4. 30-Day Free Look Period for Medigap Plans
If you switch Medigap plans, you have a 30-day “free look” period to decide whether you want to keep the new plan. During this period, you can:
Hold both the old and new Medigap plans (you must pay premiums for both during the overlap).
If you decide you prefer the new plan, you can cancel the old one within 30 days.
5. Special State Rules for Switching Medigap Plans
Some states offer more flexibility for switching Medigap plans. For example:
California and Oregon have a “birthday rule”, which allows Medigap policyholders to switch to another Medigap plan with equal or lesser benefits during the 30 days following their birthday each year.
Missouri has a “Medigap anniversary rule”, allowing you to switch to the same type of Medigap plan with another insurer during the 30 days before and after the anniversary of your plan’s purchase.
6. Reasons to Consider Switching Medigap Plans
You might want to switch Medigap plans if:
Your healthcare needs have changed: You may want more comprehensive coverage if you’re seeing more doctors or facing higher healthcare costs.
Premiums have increased: If the cost of your Medigap plan has increased significantly, you may want to shop around for a more affordable option.
You want different benefits: Some Medigap plans offer additional coverage for foreign travel emergencies, and you may want to switch to a plan that better fits your lifestyle.
7. How to Switch Medigap Plans
Compare Plans: Use the Medicare Plan Finder or contact different insurance companies to compare Medigap policies, benefits, and premiums.
Apply for a New Plan: Once you’ve selected a new plan, apply with the insurance company. Be aware that you may need to answer health questions as part of the medical underwriting process.
Wait for Approval: If approved, you can enroll in the new plan.
Cancel the Old Plan: After the new plan is active, cancel your old Medigap plan. Be sure to coordinate the start and end dates so there’s no gap in coverage.
Key Takeaways:
You can switch Medigap plans, but after your initial Medigap Open Enrollment Period, insurers may require medical underwriting, and they can deny coverage or charge higher premiums based on your health.
Guaranteed issue rights apply in certain situations, such as losing other coverage, moving, or switching from Medicare Advantage back to Medigap.
Some states have special rules, like the birthday rule or anniversary rule, that make switching Medigap plans easier.
For personalized help with switching Medigap plans or finding a new option, schedule an appointment with a Tsunami Advisor here: Schedule an Appointment.
