People are often surprised to learn that Medicare Supplement (Medigap) does not work like Medicare Advantage or Part D. There is no annual enrollment deadline. You can generally apply for a new Medigap plan any time of year. The catch is that, outside protected situations, the insurer may be allowed to ask about your health and can decline you or charge more. This guide explains the rules.
The basics: Medigap is year-round, but not guaranteed
Medigap policies are sold by private insurers and standardized by plan letter. You can apply to change carriers or plans at any time. Whether you will be accepted at the best rate depends on which protections apply to you.
Protection 1: your Medigap Open Enrollment Period
This is a one-time, six-month window that begins when you are 65 or older and enrolled in Medicare Part B. During it, insurers generally cannot deny you coverage or charge more because of your health. After it ends, you are usually subject to underwriting unless another protection applies.
Protection 2: federal guaranteed-issue rights
Federal law gives guaranteed access to certain Medigap plans in specific situations, typically with a 63-day window. Examples include:
- Your Medicare Advantage plan leaves your area or stops operating.
- You move out of your plan's service area.
- You joined Medicare Advantage when you first became eligible and leave within a trial period, generally the first year.
- Your employer or union coverage that supplemented Medicare ends.
- Your Medigap insurer goes bankrupt or ends your coverage through no fault of your own.
Timing and details matter, so check your situation before you cancel any coverage.
Protection 3: state rules and birthday rules
Some states offer additional protections. A few give a short yearly window around your birthday during which you may switch to another Medigap plan, often of equal or lesser benefits, without health questions. Details differ by state: how long the window lasts, which plans you can move to, and whether you can change insurers or only stay with your current insurer or its affiliates. These rules have been changing, so confirm the current rule with your state's Department of Insurance. See our state guides, for example Virginia and Maryland.
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Get my plan reviewWhy people change Medigap plans
- A lower premium. Medigap premiums for the same plan letter can differ a lot between carriers, and increases over time vary.
- Better service or a different rating method.
- Changing needs, such as moving from a richer plan to one with more cost-sharing.
- A move to a new state or area.
What underwriting looks like
When underwriting applies, the insurer may ask about your medical history, medications, and recent treatments. They can accept you, decline you, or in some cases offer a higher rate. Answer honestly because incorrect answers can cause problems later.
The Advantage-to-Medigap situation
If you are leaving a Medicare Advantage plan and want Medigap, check your protections first. Outside the trial period and other protected situations, insurers in many states can underwrite. See Medicare Advantage Open Enrollment and switching from Advantage back to Original Medicare.
Rating methods affect your future premium
Medigap premiums are priced in different ways: community-rated, issue-age, or attained-age. A plan that looks cheap at the start may become more expensive over time under attained-age pricing. When comparing, ask how the rate is determined and how the carrier has handled increases.
How to switch safely
- Compare plans of the same letter across carriers at your ZIP code.
- Check whether you have a guaranteed-issue right or a state birthday window.
- If underwriting applies, apply before you cancel and wait for approval.
- Confirm the effective date so there is no gap.
- Keep your confirmation letters.
A short example in words
Imagine someone who has had the same Medigap plan for several years and notices that their premium has risen faster than competitors' premiums for the same plan letter. If they live in a state with a birthday rule, they might have a short window to move to another plan without health questions. If they do not, a switch means applying and answering health questions, and being accepted is not guaranteed. In that case it may be wiser to keep the current plan, or to apply first and only cancel once the new plan is approved.
Questions to ask any insurer
Ask whether the quoted rate is guaranteed, how it is likely to change with age, whether there are household discounts, and how the company has handled rate increases historically. Ask for the effective date in writing so there is no gap.
How we help
We are an independent agency and we compare Medigap plans from multiple carriers. We will tell you honestly whether you have a protected window or whether underwriting applies. Our help is free because carriers pay us and your premium is the same either way.
Medicare help in your state
Honorbrook is licensed in the 11 states below. Plan availability, costs and some rules vary by state and county, so call us at (571) 354-0146 for what applies where you live.