There are special circumstances often referred to as Guaranteed Issuance that will allow you to enroll in Medigap with no health questions asked. You can also modify your Medicare Advantage coverage or your Medicare Part D Drug coverage during this time. These opportunities are called Special Enrollment Periods (SEPs) and they are outlined below.
SEP 1: You move your residence
If you had a Medicare Advantage Plan and then moved your residence location, you can usually switch to a new MA Plan or enroll in Medigap without medical underwriting. You have two full months (63 days for Medigap) to do so.
- You move to a new residential address that is not in your plan’s service area.
- Your new address is still in your plan’s area but now you have new options.
- You moved back into the US after living abroad.
SEP 2: You lose your present coverage
If you are Medicare eligible and lose your current coverage you can join a Medicare Advantage Plan or Medicare Prescription Drug Plan during the first two months after you lose coverage.
If you enrolled in Part A and B before losing your coverage, you get 63 days to enroll in Medigap. If you only enrolled in Part A before losing your coverage, you get 6 months to enroll in Medigap after losing your coverage. Examples of losing your present coverage include:.
- You are leaving coverage from your employer.
- You dropped your coverage in a Program for All-Inclusive Care for the Elderly (PACE).
SEP 3: You have the opportunity for other coverage
- You have the chance to enroll in other coverage offered by your employer or union.
- You enrolled or are enrolling in other coverage as good as Part D like the VA coverage.
- You enrolled in a PACE Plan.
If the above applies to you, you can drop your current Medicare Advantage Plan or Medicare Prescription Drug Plan. Give us a call at 800-930-7956.
SEP 4: Your plan changes its contract with Medicare
- Medicare sanctions your plan. Your chance to switch varies from case to case.
- Medicare terminates your plan’s contract. You can enroll or switch in between two months before and one month after your plan is terminated.
- The contract of your MA, Medicare Prescription Drug or Medicare Cost Plan is not renewed. You can enroll or switch from December 8th to the last day of February.
If the above applies to you, you can enroll in Medigap or switch from your Medicare Advantage Plan or Medicare Prescription Drug Plan to another plan. Give us a call at 800-930-7956.
SEP 5: Other circumstances
- You leave your first Medicare Advantage Plan within the first 12 months. You will have a special chance to purchase a Medigap policy with no health questions asked.
- Your employee-sponsored retiree plan continues to offer benefits but ends your supplemental coverage. You have two full months to enroll in a Medigap or Medicare Advantage plan.
- In certain states, if your Medicare Advantage plan increases your premium or co-payments by 15% or more, reduces your benefits, or ends its relationship with your doctor/medical provider, you can switch to a Medigap (usually with the same insurance company). You have two full months to use this option. This one is tricky so give us a call at 800-930-7956 for assistance.
Which Medigap Plans Can I Enroll in With SEP?
In most cases, you will receive a letter stating that you qualify for a SEP and which Medigap plans you can enroll without underwriting. Some states may have specific guidelines but most SEPs allow you to select from all available Medigap plans (state source example). Those who became Medicare eligible after 2020 may not be able to enroll in Medigap plan F.
Joining or switching Medigap, Medicare Advantage, or Medicare Prescription Drug Coverage
Please use our online quote service to find out exactly how much Medigap would cost you! Unfortunately, we are not able to show online quotes for MA or Part D so if you are looking to enroll in these plans please give us a call at 1-800-930-7956. Make sure you check out our Ultimate Guide to Medicare Insurance Switching for even more options for changing insurance plans.
We have helped hundreds of our clients switch to new coverage during special enrollment and there is never a fee for our service.