Medicare Open Enrollment Period

When are the Medicare Supplement Open Enrollment Periods?

The Medicare Supplement Open Enrollment Period for Medicare beneficiaries is based on when he or she enrolls in original Medicare Part B.  An individual can enroll in original Medicare Part A; however, he or she cannot enroll in a Medicare Supplement until he or she has an effective date established for original Medicare Part B.  Your Open Enrollment Period is the best time to buy a Medicare Supplement since the insurance company cannot ask you health questions.  The Open Enrollment Periods is:

  • When you are 65 or older AND enrolled in Part B- This period last for six months and starts on your Part B effective date.
  • If you are under 65 on Medicare disability you may be eligible for an Open Enrollment Period now. These vary by state.  Contact one of our Benefit Advisors (1-866-466-9118) to review your eligibility.

The Importance of Medicare Supplement Plan Open Enrollment Periods

Medicare Supplement Plan Open Enrollment Periods are very important periods for enrollment into a Medicare Supplement (also referred to as “Medigap”) plan because, just as guaranteed issue applications, the application does not have to go through underwriting.  Medicare Supplement Plans can be written at any time during the year; however, applying for Medicare Supplement plan outside of an open enrollment period or a guaranteed issue period does not guarantee coverage.  If an application is completed during the Medicare Supplement Plan Open Enrollment Periods then the application is considered the same as guaranteed issue because the individual cannot be denied coverage based on age, pre-existing conditions, etc.   

What does the Medicare Supplement Plan Open Enrollment Period Mean?

During the Medicare Supplement Plan Open Enrollment Periods you can apply for a new or different Medicare Supplement plan without going through underwriting.  Underwriting is defined as “the process that an insurance company uses to assess the eligibility of a customer to receive insurance coverage. Insurance underwriters evaluate the risk and exposures of potential clients and whether to approve or decline the application for coverage”.  This allows the Medicare beneficiary to shop and compare the rates and plans offered by other insurance carriers and find more affordable and/or more appropriate coverage for their Medicare insurance needs.  These Medicare Supplement Plan Open Enrollment Periods are very important to most Medicare beneficiaries simply because it allows them to secure a Medicare Supplement plan without consideration of pre-existing conditions.

Medicare Supplement Plan Open Enrollment Periods are defined as the “rights you have in certain situations when insurance companies are required by law to sell or offer you a Medicare Supplement policy. In these situations, an insurance company cannot deny you a policy, or place conditions on a policy, such as exclusions for pre-existing conditions, and cannot charge you more for a policy because of past or present health problems.”  In sum, an insurance company cannot deny you coverage due to age, pre-existing conditions, upcoming procedures or tests that have been recommended by a physician, etc.   This is clearly identifies the extreme importance of understanding Medicare Supplement Plan Open Enrollment Periods.

The following are important things to consider regarding enrollment not only in original Medicare Part A and Part B, but also the Medicare Supplement Open Enrollment Periods:

  • Enrollment into original Medicare Part A and Part B are not always automatic.  If you are already receiving Social Security benefits, then enrollment in original Medicare Part A and Part B are automatic, with an effective date being the 1st day of the month of his or her 65th birthday.  For example, if an individual turns 65 on the 28th of May and is automatically enrolled in original Medicare Part A and Part B, then his or her original Medicare will be effective May 1st.  The Medicare Supplement Open Enrollment Period will being on May 1st, as well, and will end six months later, or November 30th.
  • Exception:  For an individual whose birthday falls on the first day of the month, the he or she is deemed to have attained age 65 on the first day of the previous month. For example, an individual whose 65th birthday is October 1, 2003, will be deemed to have attained age 65 on September 1, 2003.  In this case, the Medicare Supplement Open Enrollment Period begins on September 1st, which is the same as the effective date of his or her original Medicare Part A and Part B, and will end six months later.
  • The key part of the Medicare Supplement Open Enrollment Period is the fact that the Medicare beneficiary must have both parts of original Medicare.  Since enrollment into original Medicare Part A and/or Part B is not always automatic, then naturally the Medicare Supplement Open Enrollment Period will not begin until the individual has enrolled in original Medicare Part A and Part B, and has secured and effective date for both Part A and Part B.  If the individual chooses not to enroll in original Medicare Part A and/or Part B during their original Medicare Initial Enrollment Period (which begins three months before the month of his or her 65th birthday, includes his or her birth month, and end three months after his or her birth month) then the individual may incur penalties for not enrolling during his or her original Medicare Initial Enrollment Period.
  • If the individual chooses not to enroll in original Medicare Part A and/or Part B during their Initial Enrollment Period then the time period in which he or she can enroll in original Medicare Part A and/or Part B is restricted to the Medicare General Enrollment Period.  (For more information regarding original Medicare Part A and/or Part B enrollment outside of the Initial Enrollment Period, please refer to “Medicare General Enrollment Period” in Medicare Pathways News Blog.)  If the individual chooses to wait and enroll in either original Medicare Part A and/or Part B during the Medicare General Enrollment Period his or her original Medicare will not be effective until July 1st of the same year.   Again, in order to purchase a Medicare Supplement plan the Medicare beneficiary must have original Medicare Part A and Part B.  (The same hold true for purchasing a Medicare Advantage plan – you must have original Medicare Part A and Part B to enroll in a Medicare Advantage plan.)
  • Note:  The date on which an individual applies for Medicare is generally not the same as the date on which he or she becomes entitled to benefits.  
  • Some states allow individuals to sign up for a Medicare Supplement plan up to six months prior to their 65th birthday if the individual will be automatically enrolled in original Medicare Part A and Part B, or if the individual intends to enroll in original Medicare Part A and Part B during his or her original Medicare Initial Enrollment Period to ensure that the Medicare Supplement goes into effect the same date as his or her original Medicare.   However, it is important to note that the actual Medicare Supplement Open Enrollment Period does not begin until the individual has enrolled in and has secured an effective date for original Medicare Part A and Part B.

 Note:  There are some specific states that offer Medicare Supplement Plan Open Enrollment Periods at other specific times throughout the year.

Enrollment during Medicare Supplement Plan Open Enrollment Periods Means You Cannot Be Denied

In sum, applying for a Medicare Supplement plan during the Medicare Supplement Plan Open Enrollment Periods means you cannot be denied coverage based on any health conditions, etc.  However, each Medicare Supplement Plan Open Enrollment Periods has  time restrictions that you must adhere to in order to avoid underwriting and possible denial of coverage based on pre-existing conditions, etc.  Medicare Pathways recognizes that the many enrollment periods can be confusing.  In fact, there has been recent confusion in numerous documents created and posted by numerous different sources regarding the Open Enrollment Period and the Annual Election Period.  (For more information on the Annual Election Period please refer to “What is the Annual Election Period in the Medicare Pathways News Blog.)  Based on the number of enrollment periods associated not only with original Medicare Part A and Part B, as well as Medicare Supplement plans, Medicare Advantage plans, and Prescription Drug Plans, Medicare Pathways has set out to create a series of blogs addressing the different enrollment periods, what type of plans they affect, the time restrictions involved with each, and what you can do during each enrollment period. 

A Medicare Pathways Benefit Advisor will assist you in determining if and when you may have an enrollment period, what you can do during the enrollment period, or if you are applying during a guarantee issue period, and how long you have to do it.  Also, a Benefit Advisor will assist you in finding the most affordable and most appropriate Medicare Supplement Plan at any time throughout the year because Medicare Supplement Plans can be written at any time and do not require an enrollment period.  The only difference when applying during a Medicare Supplement Plan Open Enrollment Period is the fact that you will NOT have to answer the health questions and go through the insurance company’s underwriting process.  However, each insurance company has their own set of underwriting guidelines so never assume you do not qualify to change plans.  Contact a Medicare Benefit Specialist for assistance by calling 1-866-466-9118, or simply click here to request a quote.

 

Medicare Pathways:  1-866-466-9118

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