Original Medicare, which is the program most Americans enter when they turn 65, provides good basic health insurance at an affordable price. When this coverage is paired with a Medicare Supplement Insurance plan, also known as Medigap, it becomes fantastic coverage. This combination of coverages can potentially eliminate your out of pocket costs for health care. Picking the right Medicare Supplement Insurance plan can be tricky, though. The pricing for coverage, your needs, and your budget can all change during the course of your life. In other words, at some point in time, you may want to change your Medigap plan. This article will help you answer the question, When can I change my Medicare Supplement Plan? Read on for actionable tips on this important topic.
Why Would I Want To Change My Medicare Supplement Plan?
You might be wondering this, especially since when you bought your Medigap plan you were probably told it was the best coverage available. Why would you change it? This is a fair question, and there are three reasons why you might consider switching:
- To obtain more or less comprehensive coverage
- To get a better (lower) price
- To get more or better extra benefits
We’ll review all three of these reasons in detail.
Changing To Get More Or Less Comprehensive Coverage
As wonderful as Medicare Supplement Insurance is, there are a lot of options available, which can make choosing the right policy difficult. There are ten standardized Medigap Plans. They’re identified by letter; Plans: A, B, C, D, F, G, K, L, M, and N. Each one of these plans offers a slightly different mix of coverage. Plan F is the most comprehensive plan; it covers 100% of your Medicare-approved expenses. This Plan (as well as Plan C) is now only available to people who were eligible for Medicare before January 1, 2020. Plan A is the least comprehensive Medigap plan available. It leaves several gaps in coverage – costs that you will have to pay out of pocket.
You might consider changing to a different standardized plan. For instance, if you have Plan F, but don’t feel like you need coverage that comprehensive, you might switch to Plan G or N. On the flip side, if you have Plan A, you might want to upgrade your coverage to Plan N or Plan G if you think you will want help paying for the Part A deductible, or want coverage for skilled nursing home care.
Changing To Get a Better Price
One reason many people switch their Medicare Supplement coverage is to get a lower price for the same coverage. This is generally done by switching to a different insurance company. Every insurance company sets their own premium rates for their Medigap coverage. While these premiums are subject to regulation, the insurance companies have considerable freedom to set their own prices.
For instance, there are three main methods for setting Medicare Supplement premiums, including:
- Attained Age rating – your premium is directly related to your advancing age every year
- Issue Age rating – your premium I primarily related to your age when you first buy your policy
- Community rating – everyone in the community pays the same basic rate, regardless of age
While competition between companies tends to keep their prices near each other, there can still be considerable differences in pricing. Even a difference of $10 per month can be significant. That’s a difference of $120 per year. If you keep the coverage for fifteen years, that’s a potential savings of $1,800, which is nothing to sneeze at.
Changing To Get Better Extra Benefits
Some Medicare Supplement plans come with extra benefits. These are benefits unrelated to Original Medicare, Parts A and B. Common extra benefits include:
- Gym memberships and fitness programs
- Discounts on vision, hearing, and dental services
- Dedicated 24/7 nursing hotlines for members
Not all Medigap insurers offer all of these benefits. Some offer more than this, and other offer less. They are not required to offer anything beyond coverage of Part A and B services. Many of them do, though, in an effort to attract customers.
So, When Can I Change My Medicare Supplement Plan?
If you want to change your coverage for one or more of these reasons, you’ll be glad to know that you have several options to do so. There are two different scenarios for switching:
- Switching with a Guaranteed Issue right
- Switching with medical underwriting
Guaranteed Issue is just what it sounds like. When you have this right, your acceptance for the new policy is guaranteed. You can’t be declined, or charged higher premiums based on your health conditions. You generally qualify for Guaranteed Issue for any of these reasons:
- You’re within your Medigap Open Enrollment Period (a six month window that starts when you are BOTH age 65 and in Part B)
- You have been covered by a Medicare Advantage plan and you move out of your Plan’s service area (generally this means moving to a new county or state)
- You’re in your first Medicare Advantage plan, and you’ve had it for less than 12 months (this is known as a Trial Right)
- Your Medicare Advantage plan doesn’t renew its contract with CMS
- Your Medicare Supplement Insurer goes bankrupt
There are a few other ways to qualify for Guaranteed Issue, but they’re pretty rare.
Changing Your Medicare Supplement Plan Without Guaranteed Issue Rights
Using a Guaranteed Issue right is the easiest way to change Medigap plans, but you still have the ability to switch if you don’t qualify for one. In fact, you can apply for different Medigap coverage at any time. You don’t have to wait for any kind of enrollment period like you do for Medicare Advantage or Prescription Drug Plans. It’s always open season for changing Medigap coverage.
In this case, you will have to submit to Medical Underwriting. This means that you’ll be asked health related questions. Certain health conditions make it impossible to get qualify for Medigap. Other conditions affect the premium you’ll pay. The criteria for underwriting are generally not too strict. Having common ailments like high blood pressure or cholesterol are usually not a problem. On the other hand, recent history of cancer or heart or vascular problems like heart attacks and strokes will usually prevent you from qualifying for the best rate.
Each insurance company has its own underwriting criteria, so some are easier to get coverage with than others for certain conditions. This is a great reason to work with an independent health insurance agent. They are familiar with the underwriting criteria of multiple insurance companies. They can help you select a plan that’s likely to accept you based on your health. The great news is that there’s no downside to applying for a change in Medicare Supplement plan. If you’re declined, you still have your existing coverage.
This article has addressed the question, When can I change My Medicare Supplement plan? If you’re interested in saving money on your Medicare Supplement plan, or if you want to switch from one standardized plan to another, reach out to us today. We can help you compare quotes from multiple insurance companies, and help you find a plan that fits your needs and budget. Best of all, you never pay us a penny, so give us a call today for a free consultation.