Can I buy a Medigap after I first become eligible for Medicare?

Dear Arthur, 

Generally, the best time to enroll in a Medigap policy is during your Medigap open enrollment period. This is the six-month period that begins the month you are 65 or older and enrolled in Medicare Part B. If you miss your Medigap open enrollment period, you can also buy a Medigap if you have a guaranteed issue right.  

When you have a guaranteed issue right, companies must sell you a Medigap policy at the best available rate, regardless of your health status, and can’t deny you coverage or impose waiting periods for pre-existing conditions. Depending on your state’s rules, the best available rate can still vary based on some factors–including age, gender, and whether you smoke. Check with your State Health Insurance Assistance Program (SHIP) to help ensure that you are getting the best available rate for your Medigap.   

You may have a guaranteed issue right if: 

• You, through no fault of your own, lost a group health plan (GHP) that covered your Medicare cost-sharing (meaning it paid secondary to Medicare). 
• You joined a Medicare Advantage Plan when you first became eligible for Medicare and disenrolled within 12 months. 
• You have a Medicare Advantage Plan, Medicare SELECT policy, or PACE program and you move out of the plan’s service area. 
• Your previous Medigap policy, Medicare Advantage Plan, or PACE program ends its coverage or commits fraud. 

Be sure to keep a copy of any letters, notices, postmarked envelopes, and claim denials in case you need proof that you lost or ended health coverage. Medigap insurers might require these documents before they sell you a policy. 

Your state may have other protected times for purchasing a Medigap. Check with your SHIP or State Department of Insurance to learn more about state-specific Medigap rules.  

You can run into problems if you try to buy a Medigap policy outside a protected enrollment period. Companies can refuse to sell you one entirely. If a company does agree to sell you a policy, you might need to pay a higher monthly premium and may be subject to a six-month waiting period before the Medigap will cover pre-existing conditions. Contact Medigap insurers in your state to learn if they will sell you a Medigap policy outside protected enrollment periods. 

Hope this helps!  

– Marci