A Guide to Switching Medigap Plans
Medicare is reasonably flexible about letting you change your mind if you want to change Medicare Supplement plans. The conditions that apply are that you be within the 6-month Open Enrollment Period or you have what are called “guaranteed issue rights,” which we will explain in full.
The most common reasons people want to switch plans are:
You’re free to take a test ride
Everyone is given a 30 day “free look” period to see if their new Medigap policy is a good fit for their needs, and you get to keep your old plan before canceling it during that time period. It’s key that you do not cancel your original Medigap plan until you’re certain you want to keep the new policy. To help you keep your commitment, the application for your second policy requires that you promise to cancel the first policy. You’ll also have to cover both premiums while the “free look” period lasts.
Keep in the back of your mind that cancelling your original policy beyond the 30-day “free look” period means you won’t be able to pick it up again as it will no longer be available as a standardized Medigap policy.
What’s involved with switching?
To research new plans, simply go to your State Health Insurance Department to see which Medigap policies are sold in your state. Once you’re ready to switch, you need to contact the new carrier and request an application. On acceptance, call your present insurer and ask for your coverage to be terminated — they will explain how to submit the request.
After switching plans, there may be a wait period for specific benefits. In the case where you’re outside the Open Enrollment Period and have a pre-existing condition that the insurer allows, you may have a delay in getting coverage for treatment related to that condition. How long could the wait be? Perhaps up to six months.
What if I want to switch plans after my Open Enrollment Period?
Once the OEP has passed, an existing health condition can keep you from getting a new Medigap policy. Insurers can delay your coverage, or hit you with a higher premium for the same reason. It’s within the company’s rights to ask for a medical underwriting review before allowing you to enroll. This is where the guaranteed issue rights come in.
Here are some of the exceptions you can present to the insurer:
You might have additional situations which qualify you for a “trial right” to buy a Medigap policy. We recommend you shop around and see if insurance companies in your state will allow you to change Medicare Supplement insurance plans. Also, call a medigapcoverage.com powered by pollen™ specialist to see whether guaranteed-issue Medgap policies can be bought where you live. If it’s likely you will be eligible for guaranteed issue rights later, you might want to reconsider keeping your current Medigap plan and paying a monthly premium for benefits you can’t use.
Note that if you are currently enrolled into a Medicare Advantage plan, it’s illegal for insurance companies to sell you a Medigap policy: you can’t have both.
The other way you can qualify for guaranteed issue into a Medicare Supplement insurance plan your medical history notwithstanding, is if you’ve met specific criteria, such as applying during your Medicare Supplement Open Enrollment Period. Further guaranteed issues rights may be available pending conditions that existed before the policy began. Pre-existing conditions may affect coverage, exclude you from coverage, or stop your policy from being approved. The limitations or exclusions of coverage varies with each plan. Please review each plan’s official plan documents to find out that plan’s policy on pre-existing conditions.
When should I hang onto my current Medigap plan?
If your Medigap policy is not being offered now, weigh your options before changing plans. Your Medigap policy may have different coverage than what’s available currently. Medigap policies sold after January 1, 2006, for one example, don’t include prescription drug coverage. If you bought your plan prior to that date, you’re allowed to — and should — keep the older policy. Holding onto your older Medigap policy with prescription drug coverage makes obvious sense if buying a new one is guaranteed to raise your out-of-pocket costs for prescription drugs.
With all that in mind, be aware that a new Medicare Supplement insurance plan may come with advantages your plan doesn’t have, guaranteed renewability or a lower premium just two examples. Always factor in your health needs at this time in your life, and comparison shop for the best fit.
What if I want Medigap after leaving a Medicare Advantage plan?
As we pointed out above, it’s illegal for an insurance company to sell you a Medigap plan If you are currently enrolled in a Medicare Advantage plan. But you still have the chance to sign up for a Medicare Supplement plan at a later date. Remember, your Medigap Open Enrollment Period starts the first month you enroll in Medicare Part B and not the first month you are eligible for Medicare. You may be eligible for guaranteed-issue right to enroll in Medigap at the time you need Medicare Part B, even if you put off Part B enrollment or your automatic enrollment was terminated.
If you dropped your Medigap policy to switch to a Medicare Advantage plan, you most likely can get the plan back if you sign up for Original Medicare within a year. This falls under your “trial right” to give a Medicare Advantage plan a try. Should your Medicare Advantage plan be unavailable when you want to switch back, you can buy guaranteed-issue Medigap plans A, B, C, F, K, or L offered by any insurance carrier in your state. Your other trial right is if you joined a Medicare Advantage plan or Programs of All-inclusive Care for the Elderly (PACE) when you turned 65, and opted to switch to Plans A and B within the initial year.
If I have a Medicare Advantage plan am I able to drop Medigap?
The only time you should do this is if you sign up for a Medicare Advantage plan, simply because you can’t use Medigap benefits at the same time you’re enrolled in Medicare Advantage. Not to mention the fact it’s illegal to sell you one while you have the other, as covered previously.
Our strong recommendation is to hang on to your Medigap plan if you’re considering a return to Parts A or B down the line. You’ll still have to pay the premium and Medigap won’t cover out-of-pocket costs when you’re enrolled in a Medicare Advantage plan. Remember, your Medigap policy doesn’t pay for Medicare Advantage plan’s premiums, copayments, or deductibles.
Still confused? Call us!
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I’m interested in trying a different Medicare Supplement plan, but I don’t want to lose the one I have now. What can I do?
You’re entitled to a 30-day “free look” period during which you can try the new plan. You’ll have to commit to cancelling the other plan if you decide to switch and you have to pay premiums for both while the trial period lasts.
I have a pre-existing condition, but am able to switch Medigap plans through a guaranteed trial right. Can the insurance company still make me pay for my health condition?
In some cases, the carrier can delay health care service coverage for a pre-existing condition up to 6 months.
I dropped my Medigap plan when I signed up for a Medicare Advantage policy. Now I want it reinstated — is that possible?
Yes, you have what’s called a “trial right” to see if you like a Medicare Advantage plan. This allows you to re-enroll in your old Medigap plan, whether you keep the Medicare Advantage plan or not.
I’ve had a Medicare Supplement plan for more than a decade and I’m thinking about “upgrading” to a new plan. What do I need to know to be sure I’m making the right decision?
2023 plans have a range of benefits and costs. Our main caveat is that if you have a Medigap plan from before January 1st, 2006, it may well include prescription drug coverage which current plans lack. If you plan to use this benefit, by all means hold onto your old plan!
- Best overall Medicare supplement for new enrollees: Plan G.
- Best overall Medicare supplement before 2020: Plan F.
- Best low cost Medicare supplement: Plan K.
- Best alternative to Plan G Medicare supplement: Plan N.
Medicare Supplement policies are private health insurance designed to cover gaps in Original Medicare. They are also known as Medigap plans. These take care of costs such as copays, coinsurance, and deductibles which can become expensive if you need regular care from a doctor or hospital. If you need medical care while traveling outside the U.S., you can buy Medigap policies to help cover those costs. As a supplement to Original Medicare, you’re required to have Part A and Part B before you canget a Medigap policy. This way, Medicare is responsible for the Medicare-approved costs of the covered care, and the remainder is covered by your Medigap plan.
Optimal coverage comes with higher costs, making Plan F the most expensive Medigap plan. Plan F is known as “first-dollar coverage” and it takes care of everything provided during a doctor or hospital visit. Your only responsibility is for dental, vision, medications, and equipment, such as hearing aids.
The Federal government ended the Plan F option for new enrollees last year to keep the healthcare system from being overused by patients who had their deductibles covered. The next best coverage after Plan F is Plan G.
Medigap Plan G offers every advantage of Plan F except for the deductible, which you have to cover. Because it isn’t as comprehensive as Plan F, Plan G is more affordable.
For people who don’t go to the doctor often, Plan K is worth considering. It is the most affordable because it provides just 50% of Medicare Part B coinsurance, the Part A deductible, blood, skilled nursing, and Part A hospice costs. For comparison, Plan G and others offer full coverage of these expenses, and more.
It’s hard to argue against plans which cut your traditional Medicare costs. For most people, having the extra coverage these supplemental plans provide is common sense, unless they want the specific features of a Medicare Advantage plan.
Most people would benefit from not having to pay out-of-pocket to stay healthy. Medicare supplement insurance or a Medicare Advantage plan offer vital savings now, but are indispensable should a catastrophic health issue occur.
Of the 10 Medicare-approved Medigap plans, Plan G and Plan N are the most popular. Plan F is no longer available to new Medicare enrollees as of 2020, but it is still popular among people who bought this plan prior to 2020.
- Plan F$128–$342
- Plan F (high deductible)$22–$88
- Plan G$106–$325
- Plan G (high deductible)$29–$58
Before getting a Medicare supplement plan, you need to be enrolled in Medicare Part A (hospital insurance) and Part B (medical insurance). People with Medicare Advantage Plans who want to go back to Original Medicare can buy a Medigap policy prior to switching.
The security of having lower or no out-of-pocket healthcare costs can offset the premiums you’ll have to pay for whichever Medigap plan you choose, which vary depending on the benefits offered.
The national average cost for Medicare Supplement Plan F is $1,824 annually, which is $152/month; Medigap Plan G will cost you around $143 per month.
Since Plan F was discontinued for new enrollees as of 2020, Plan G offers the most coverage for people 65 and older. It has a lower premium than Plan F and duplicates its benefits, except for the Part B deductible.
It depends on your specific needs, but for most people a Medigap plan is very useful in supplementing the coverage of Medicare Part A and Part B. A Medicare Advantage plan is an affordable way to get healthcare coverage not offered by Original Medicare.
Historically, Plan F has been the most popular because it covers all the out-of-pocket costs Medicare does’t pay for. This includes the 15% extra charge billed by providers who do not take Medicare as full payment.