What do I do if the Open Enrollment Period for Purchasing a Medigap Policy has Passed?

Pay Attention to Your Medigap Enrollment Periods

Missing either your open enrollment period or your Initial enrollment periods is a very bad thing unless you have an excuse that will qualify for Special Enrollment. Your Open Enrollment Period for a getting a Supplemental policy begins six months after you have enrolled in Original Medicare Part B and are at least sixty-five years old. This is the best time to buy a Supplemental policy because you have "guaranteed issue rights." The Medigap insurance company must give you coverage and they can't charge you more for getting it even if you have a pre-existing condition. One exception to this rule exists: If you have a pre-existing condition and have not had insurance coverage for a continuous six-month period prior to getting Medicare the company has the right to delay your policy. However, they cannot refuse to cover you.

Once the Open Enrollment Period has passed you may still be able to get a Medigap policy but the guaranteed issue rights that you had during your enrollment period no longer apply. This means that the insurance company can put you through full underwriting and charge you accordingly. They also have the right to deny you coverage. Depending on your situation you may still want to buy the Medigap plan at the higher rate but shopping around for the cheapest plan with the best coverage is even more important after you have missed the 6-month Medigap Open Enrollment Period.

Medigap Enrollment Under Special Circumstances

Special Circumstances give you the ability to buy your plan later, replace it and stop and restart coverage. For example, if either you or your spouse is employed or goes back to work and has employee medical coverage you have the right to delay starting your Original Medicare Part B coverage. Contact Social Security and inform them before you turn 65 that you want to delay coverage. If you delay Part B coverage due to employment you are also delaying the start of your Medigap 6-month Open Enrollment Period. Similarly, if you or your spouse goes back to work you have the right to suspend your Medigap coverage (for up to two years) and pick it back up again later.

Auntie Lou says, "The key thing to remember is you only get ONE Medigap Open Enrollment Period that starts when you are older than 65 and signed up for Original Medicare Part B. You can delay your Open Enrollment Period if you're working but once the clock starts ticking you get one shot to make this choice- well sort of- they give you a year 'trial period' during which time you can change your mind. Go figure."

In summary, if you miss the Medigap Open Enrollment Period you may still be able to buy a Medigap policy but the company has the right to charge you more, deny you coverage, delay the start of the coverage and do basically anything else they want to make the policy more advantageous for them. Depending on your situation you may still want to purchase a Medigap policy.