Many people choose a Medicare Supplement plan, also called Medigap, when they first enroll in Medicare. Later, they may wonder if they can switch plans. Maybe their premium has increased, their health needs have changed, or they want different coverage.
The short answer is that you may be able to change Medicare Supplement plans at any time. However, the process is not always as simple as changing a Medicare Part D drug plan during the fall. In many cases, you may need to answer health questions and be approved by the new insurance company.
Knowing the rules before you apply can help you avoid a coverage gap or an unexpected denial.
Can you switch Medicare Supplement plans anytime?
Generally, there is no once-a-year enrollment period that limits when you can apply for a new Medicare Supplement plan. You can often apply for a different Medigap plan during the year.
But being allowed to apply does not always mean the new carrier must accept your application. Outside certain protected situations, insurance companies can usually use medical underwriting. Medical underwriting means the company may ask about your health history, medications, recent hospital stays, and certain medical conditions before deciding whether to offer you coverage.
If you are approved, the new plan may have a different premium and may offer different benefits. Premiums and availability can vary by carrier, plan, location, age, and state.
When can you switch without health questions?
There are some situations where you may have a guaranteed-issue right. This is a consumer protection that can require certain Medicare Supplement insurers to sell you a plan without using medical underwriting.
Guaranteed-issue rights often apply when you lose certain types of health coverage through no fault of your own. For example, you may have a protected right if:
- You leave a Medicare Advantage plan because it is leaving Medicare or no longer serves your area.
- You move out of your Medicare Advantage plan’s service area.
- You have a Medicare Advantage plan that misled you or failed to follow Medicare rules.
- You lose employer or union retiree coverage that works with Medicare.
- You return to Original Medicare after trying a Medicare Advantage plan for the first time in certain situations.
The details matter. Guaranteed-issue rules may limit the types of Medicare Supplement plans available to you, and deadlines can be short. State rules may also provide extra protections beyond the federal rules.
It is a good idea to keep letters showing that your old coverage ended. The new insurer may ask for proof that you qualify for guaranteed issue.
What if you are healthy enough to pass underwriting?
If you do not have a guaranteed-issue right, you can still apply to switch plans. Many people do this when they want to compare premiums or move to a plan with a different cost-sharing structure.
For example, someone with Plan G may want to compare other Plan G options from different carriers. Medicare Supplement plans with the same letter generally have the same standardized benefits in most states. That means one company’s Plan G generally covers the same basic Medicare-approved benefits as another company’s Plan G. The premium, customer service, rate history, household discounts, and underwriting rules may differ.
Someone with Plan N may decide they prefer Plan G, or the other way around. Plan N can have lower premiums in some areas but may include copayments for certain office or emergency room visits and does not cover Part B excess charges. Plan G generally has broader coverage after you meet the Part B deductible. The right choice depends on your budget, comfort with out-of-pocket costs, and the doctors you see.
Do not cancel your current plan too soon
This is one of the most important steps when changing Medicare Supplement coverage. Do not cancel your current policy until the new plan has been approved and you know its effective date.
In many cases, you may have a short period to review the new policy while keeping your old plan. This can give you time to make sure the new coverage is what you expected. You should not keep two Medicare Supplement plans for the same benefits long term, but a brief overlap may help prevent a gap in coverage.
Before ending your old policy, confirm the following:
- Your new application has been approved.
- You understand the new plan’s monthly premium.
- You know the effective date of the new coverage.
- You have reviewed any waiting periods or limitations that may apply.
- You have checked how the change may affect your Part D drug plan, if applicable.
Does the Annual Enrollment Period let you change Medigap plans?
The Annual Enrollment Period runs each fall and is well known because people can make changes to Medicare Advantage and Part D prescription drug plans. However, it does not create an automatic right to change Medicare Supplement plans without underwriting.
You may still apply for a Medigap plan during the fall, but the same underwriting or guaranteed-issue rules generally apply. This can be confusing because the fall enrollment period is important for other Medicare decisions.
If you have a Medicare Advantage plan and want to return to Original Medicare with a Medicare Supplement plan, timing can be especially important. You may need to apply for the supplement before dropping your Medicare Advantage plan, since you may not be guaranteed approval for Medigap coverage.
What should you compare before changing plans?
A lower premium is important, but it should not be the only factor. Consider the total value of the coverage and whether the plan fits your needs now and in the future.
- Compare the plan letter and benefits carefully.
- Ask whether your doctors accept Medicare assignment.
- Review your likely out-of-pocket costs.
- Check the carrier’s rate history and available discounts.
- Understand whether the carrier will require medical underwriting.
- Make sure your prescription drug coverage remains in place if you need Part D.
Changing Medicare Supplement plans can be worthwhile in the right situation, but it is best to review the details before making a move. Eric can help you compare available Medicare Supplement options, understand underwriting rules, and review your choices at no cost and with no pressure.