Medicare Supplement plans (aka Medigap) can charge more for smokers depending on when they apply. Medical underwriting is required by Medigap plans when you apply outside guaranteed issued periods and this may result in higher premiums for smokers. According to our analysis of pricing, rates are roughly 10% higher if you smoke and don’t qualify for guaranteed issued coverage. There is one loophole, which we detail below, when Medigap cannot charge you more even if you are a smoker.
When Can Smokers Apply for Medigap and NOT be Charged More?
Smokers must qualify for guaranteed issued Medigap coverage to avoid paying more than everyone else. This is the loophole to save smokers money. The Initial Enrollment Period is the most straightforward way of qualifying for guaranteed issued Medigap. Sometimes called Medicare Supplement Open Enrollment Period, Medigap’s Initial Enrollment Period means you are not subjected to medical underwriting or higher prices. Initial Enrollment starts the month you have both turned 65 or older and enrolled in Medicare Part B. Everyone gets an Initial Enrollment Period so all smokers could avoid extra fees if they applied for Medigap when first eligible.
What are Other Medigap Guaranteed Issues Periods for Smokers
If you have missed your Initial Enrollment Period, you may qualify for other guaranteed-issue rights on certain plans. Remember insurance companies cannot raise your Medicare premiums because of pre-existing conditions or the fact that you smoke during Medigap Guaranteed Issued periods.
Below are some examples of other Medigap rights where they cannot increase your price if you are a smoker
- Your coverage through work ends (including COBRA).
- Your current Medicare Advantage plan has stopped being offered under Medicare.
- You’ve completed the first year of a Medicare Advantage plan “trial period” and want to return to Original Medicare and purchase a Medicare Supplement insurance policy.
- If you move out of your service plan’s service area or your policy ceases to cover your location
- You lose your Medicare Supplement insurance plan through no fault of your own.
Note: Certain Medigap Plans like N and M do NOT qualify for Guaranteed Issuance Period/Special Enrollment Period outside your initial/open enrollment.
Some areas also have state-specific laws that might extend Medigap guaranteed-issue rights to other situations. Check out our page on the Ultimate Medigap Switching Guide for more ways to switch to Medigap.
Get an instant Medigap quote here. Prices usually do not include increases for smokers. Contact our office to see if you will have a smoking cost increase.
Smoker Options Outside of Guaranteed Issues Situations
You might end up paying more for your Medigap policy if you have a history of tobacco use and do not qualify for any of the options listed in the section above. Insurers are allowed to underwrite you and charge smokers more.
Insurance companies consider a variety of variables during underwriting, including age, location, gender, health history, and tobacco use. Because smoke from cigarettes has been linked to an increased risk of serious health conditions (including cancer, heart disease, and strokes), insurance companies usually charge smokers more in order to account for the additional health-care expenditures. Senior65.com estimates in a cost increase to be about 10% but it varies with each insurance provider.
Even if you are charged more for smoking, you should still consider applying for Medigap as it can save you $1000’s that you would normally pay in Medicare deductibles and co-insurance. If you are a smoker, you know you are at higher risk of serious medical conditions so you might as well protect yourself from high medical bills.
If I Give Up Smoking will I Pay Less for Medigap?
Once again the answer is “it depends,” Each insurance company handles its definition of smoking differently. Many ask “have you used any tobacco product in the last 6 months. ” Others expand the window of smoking to “the last two years.” So if you quit 3 years ago, you usually will be treated as a non-smoker and not pay more. If you just quit last week, you will be out of luck.
We can help you identify exactly how the Medigap applications ask about smoking to match your situation with the plan with the best price. Give us a call at 800-930-7956.