Topics:Buying health insurance health care Open Enrollment health insurance guides Health and wellness Medicare research
May 7th, 2021
May 7th, 2021
Updated September 10, 2021. Medicare Open Enrollment for 2022 coverage runs October 15, 2021 to December 7, 2021. It's a good opportunity for people with Original Medicare to evaluate if a Medicare Advantage plan might be better and vice versa. It's also important to double-check your Part D prescription drug coverage for 2022. To make the most of Medicare Annual Enrollment, it’s a good idea to research and prepare. You should also be aware of pitfalls to avoid during the once-per-year enrollment period. Here are five pitfalls that Medicare experts identified: Not looking for changes Not considering other plans Not enrolling in Part D Following ill-advised recommendations Procrastinating Not looking for changes The saying “The more things change, the more things stay the same” does not apply to Medicare plans. When a Medicare plan is changed, the coverage is not the same. Insurance companies make changes to the coverage and costs each of their plans have. Double-checking to make sure your prescriptions are covered is important to do each year. John Hill, Gateway Retirement President“The biggest pitfall is assuming things are the same. Medicare seems to be always changing. The next pitfall is timing, you have from October 15 until December 7 to make your selections for your drug plan or Medicare Advantage plan. If you assume your Medicare Advantage plan or drug coverage is the same, you may be disappointed.” Adam Hyers, Hyers and Associates, Inc“Oftentimes, Part D plans will change their premiums and copays while also moving certain drugs into different (more expensive) tiers or out of formulary altogether. By the time someone might realize this in January, it can be too late to do anything about it. Part D plans are required to send out an ANOC (Annual Notice of Changes) form for all Part D and Medicare Advantage plans, but sometimes they are lost or ignored. Consumers should never assume their drug plan will stay the same year over year. They should contact their agent to make sure or double check their prescriptions using the Plan Finder tool at Medicare.gov. Enrolling the most suitable plan can save people hundreds of dollars or more for the next year.” Danielle R. Plummer, PharmD Consultant Pharmacist“Insurance companies are constantly changing their formularies, so just because a medication was on the lowest tier formulary this year, it may not be the next. If you are not comfortable using the internet, ask for help through local library, insurance brokers, and pharmacies. If a chain pharmacy does not have time to work with you, check with your local independent pharmacies. Insurance contracts also change which pharmacy is their preferred provider year to year, so don't assume that the pharmacy you've been using will still have the lowest copays for your plan. Call your plan to ask which pharmacy is preferred. Also ask about copays at independent pharmacies and mail order options.” Not considering other plans As Medicare health plans change and your health situation changes, it’s important not to assume that your current plan will always be best for you. By considering all your plan options for Medicare Advantage and Part D, you’ll make sure that you’ve got a plan that meets your health and budgetary needs. Kathryn Casna, Eligibility.com“Many plans change each year, so look for your plan's Annual Notice of Change (ANOC) in the mail in October, and make sure the plan still meets your needs. On the flip side, it never hurts to call an agent or run your info through the plan finder at Medicare.gov each year to see if you can get a better plan or a lower price elsewhere.” Not enrolling in Part D Medications and prescriptions are important, especially if you rely on a daily medication. If you don’t currently take medications, it may not make sense to enroll in prescription drug coverage. But, if you eventually do need medication and have not had prescription drug coverage, your costs may be higher down the road. Alex Enabnit, Eligibility.com“If you don’t have drug coverage but anticipate needing it at some point in the future, find a Part D plan during AEP. If you know you’ll never want drug coverage, that’s fine. But if at some point you will, you need to know that Medicare enforces a penalty charge for every month you went without drug coverage. This penalty remains in force, monthly, for the rest of your life. Yes, you read that right. Avoid this pitfall!” Following ill-advised recommendations Lots of people get advice from family members and friends for some major life decisions. While it’s nice to have a good support network, it’s important to realize that everyone’s health and financial situation is different. A plan that worked well for your friend may not be great for you. Kathryn Casna, Eligibility.com“Medicare beneficiaries will get tons of recommendations this season, but unless those recommendations are closely matched to your individual situation, you could be enrolling in the wrong plan. Both of these pitfalls can be side-stepped with a bit of research into the plans that fit your individual needs.” Procrastinating Don’t underestimate how long the underwriting and approval process can take when enrolling in a new Medicare plan. You’ll want to know if your application has been declined with plenty of time to apply for another. Danielle K. Roberts, Boomer Benefits“It’s important to start early. Don’t procrastinate until the end of the enrollment period because both insurance companies and Medicare get swamped with applications. There are longer hold times if you call in with a question. You also need adequate time to research your options so that you are not rushing to choose a plan. Another pitfall can occur if you are wanting to disenroll from a Medicare Advantage plan and return to Original Medicare and add a Medigap plan. In most cases you must answer health questions on the application for Medigap and the insurance company needs to time to decide whether they will accept for decline you. So it’s important that you apply for the Medigap plan first and well in advance of the December 7th deadline. Don’t cancel your Medicare Advantage plan until you have received approval from the Medigap carrier that they are granting you a policy.” Avoiding pitfalls Avoiding these Medicare Annual Enrollment pitfalls will help you find an affordable plan that meets your coverage needs. Reviewing any changes, double-checking prescription coverage and costs, and applying early in the enrollment period will help you decide if it's best to stick to your current plan or make a change.
Updated Septeber 10, 2021. Medicare Open Enrollment is a valuable opportunity to re-evaluate your Medicare plan, review Medicare options, and even find a better plan. The Annual Enrollment Period for coverage during 2022 runs October 15th through December 7th. Preparing for Annual Enrollment can help you take full advantage of this opportunity to make sure that your Medicare plans meet your needs. Here are three things you can do to be ready for this year’s Annual Enrollment Period: Analyze this year’s health costs Do your research Set an appointment with an agent Analyze this year’s health costs “People should prepare for Medicare Annual Enrollment by reviewing their health care utilization this past year and thinking about anticipated utilization and needs for the coming year,” advises Gayle Byck, PhD, Board Certified Patient Advocate, Certified Senior Advisor®, and founder of InTune Health Advocates, LLC. Understanding what you spent on health care this year can help you project costs for next year. As you think about how much your health plan costs, be sure to include the monthly premiums and all out-of-pocket expenses. Out-of-pocket expenses are the costs you paid for prescriptions, doctor visits, and treatment. While you’re evaluating this year’s costs, it’s important to consider how well your current plan met your coverage needs. While it can be less work to stay on the same plan, it’s not worth staying if there are cheaper options that offer better coverage. Byck recommends considering this question as you evaluate your current plan: Does your current plan (A, B, Supplement, and D, or Medicare Advantage) continue to meet your needs and make the most financial sense? As you evaluate the total cost of your plan and other health plans you are considering, include the monthly premiums and all out-of-pocket expenses. It’s important to do this in-depth analysis, especially if you’re considering switching between Original Medicare and a Medicare Advantage plan. While this kind of evaluation can be tedious and time-consuming, it’s worth it. If you’re living on retirement savings, you only have a certain amount that you can spend. It’s important to find the most cost-effective plan with the coverage you need to make your retirement savings last as long as possible. Do your research Medicare Advantage and Medicare Part D (Prescription Drug Plans) change every year. Additionally, companies offer new plans. There are a couple of important things to research about your current plan and for any new plan you consider: Changes New plans Coverage Cost saving resources Changes Make sure you know how your plans are changing by doing your own research. There are several great resources to help you understand how your current plans are changing, like Medicare.gov and Annual Notice of Change (ANOC) letters. Medicare.gov Troy Baccus, Medicare Life Group owner, suggests using Medicare.gov reports to check for changes in your Prescrption Drug Plan (PDP): “The best thing you can do to prepare for AEP is run a new prescription drug plan report on Medicare.gov. You'll want to wait until at least October 1 to run the report and make sure you are running the report for the year 2022 (it may default to the current 2021). Running a prescription drug plan report will help you confirm your current plan is still your best option for 2022. If not, you can usually enroll in the another plan directly from the Medicare.gov website.” Annual Notice Of Change Danielle K. Roberts, Boomer Benefits founder, suggests reading the Annual Notice of Change letter:“Review your Annual Notice of Change letter from your current Part D or Medicare Advantage carrier. You will receive this by mail in September. Look for what is changing that might affect you. Is the premium going up? Have your copays substantially increased? Are they dropping any of your important medications? If you find something you don’t like, then you have an opportunity to make a change during the upcoming OEP that begins on October 15th. Make a list of all your current medications, including dosage and frequency. You can enter these into the Plan Finder Tool on Medicare.gov website beginning in October. This will help you to search for plans that you know will cover your necessary medications.” New plans Because Medicare Advantage plans are privately operated by companies, companies can release new plans every year that can be a better option than your current plan. “New Medicare Advantage plans may be available in 2022 that provide superior coverage to your current plan. The easiest approach to review your Medicare Advantage plan is speaking with an independent agent. Just make sure they've got your best interest in mind and aren't looking to make a quick sale (we recommend checking out their Google reviews, if possible),” suggests Baccus. Coverage Coverage and access to your doctors are some of the most important things you need to double-check for your Medicare plans. To be clear, you can always see any doctor you like, but the cost-sharing available from your plan based on what plans your doctor accepts will affect how high your health care expenses are. “Reviewing your plan every AEP is important. Not only will you want to make sure your current plan will remain your best option for prescription coverage in 2022, but you'll also want to confirm your doctor will remain in network,” says Baccus. When checking your coverage, it’s a good idea to do your own research instead of relying on third-party information. “Please do not take a salesperson’s word for your network coverage, call your providers and ask – “will you be taking this specific plan next year?” Why specific? Because some companies have multiple plans, and your provider may not take them all. Going to medicare.gov is a safe recourse to get the facts,” recommends John Hill, President of Gateway Retirement. Cost saving resources Each state has federally funded programs to help people pay their Medicare premiums, typically for Original Medicare. If you qualify and apply, you may be eligible to participate in some of these Medicare Savings Programs. “During enrollment, be sure to look into the various savings programs available that can help pay for premiums, out-of-pocket costs, prescription costs and more. There are a number of services available and utilizing them can help you save money,” suggests Michael Stahl, HealthMarkets Executive Vice President and Chief Marketing Officer. Set an appointment with an agent If you’re new to Medicare or want help evaluating plans, meeting with an independent agent can be a smart move. “I always stress the importance of sitting down with a licensed, non-biased insurance agent who can provide information on Medicare, what is or is not covered, and pricing so you can be informed when it comes time to make decisions during enrollment and choosing your Medicare provider(s),” says Stahl. While experienced and knowledgeable agents can offer valuable insight and assistance with Medicare plans, it’s important to find a trustworthy one. “Seniors should find a solid broker with a consistent track record of providing value in the senior community and giving unbiased advice,” says Christopher Westfall, Sr, Senior Savings Network founder. Looking at client reviews and taking recommendations from friends can help you find a reliable agent. Beyond considering reviews, Medicare has rules regarding what insurance agents selling Medicare can and can't do when working with clients. Understanding these can help you identify good agents. Knowing that you’re getting good advice can be difficult to determine, especially if you’re not familiar with Medicare. If you want to be an informed decision-maker, it’s worthwhile to do your own research. “Do your own research rather than only relying on information from insurance agents. There are quality rating systems online and free resources from your state’s Senior Health Insurance Program,” advises Byck. Preparing for Medicare Annual Enrollment Understanding your health care expenses and coverage levels from this year will help you forecast costs for next year. It will also help you determine if it’s best to stick to your current plan or if another Medicare plan would be better. It’s also essential to be aware of any changes to current plans for next year. Knowing these changes will also help ensure that you enroll in the coverage you need in 2022. Working with a good agent can also help you understand your options and make an informed choice. Even working with an agent, do your own research so that you can ask these important questions and get the information you need to make the best choice for your health plan.
Guest Post by Danielle K. Roberts When your Medicare benefits begin, your Part B effective date kicks off a 6-month open enrollment window during which new Medicare beneficiaries can enroll in any Medigap plan with no health questions asked. However, once that window has passed, changing plans will require underwriting in most states. We often get asked about what this underwriting entails. Here’s what you need to know: It starts with your application Medigap applications come with a page of health questions which you must answer if you are not in your open enrollment period or a guaranteed issue period after rolling off employer insurance. In most instances, the insurance carrier wants you to be able to answer “no” to all the health questions. Some insurance companies won’t allow any “yes” answers at all and instruct the agent to automatically decline the application if the applicant answers yes to any questions. While chronic conditions like COPD or congestive heart failure will often cause an automatic decline, other things won’t necessarily be a problem. For instance, if you take a few routine medications, such as a blood pressure medication or a thyroid medication, these are often not a problem if they aren’t part of treating a larger health condition. On the flip side of that, just because you answer “no” to all of the health questions doesn’t mean you will be approved. This is just the first step that qualifies your entry into the underwriting process. Ultimately, the underwriter at the insurance company will decide whether to approve you after reviewing your application and medical records they can find. Medical questions vary by company, so if you can’t pass one carrier’s health questions, your agent may know of another carrier that has different questions. He or she may suggest that you apply there instead to give you the best chance of being approved. You can find some examples of underwriting questions here. Apply after any pending medical appointments When applying for a Medigap plan, you should do so after you have completed any pending medical procedures, surgeries, or follow-ups. Something as small as one last pending physical therapy session after a surgery that occurred months ago can cause a decline. If you have any kind of medical follow-up appointment on your calendar, get that done first and then apply for your Medigap plan afterward. Your prescriptions matter Underwriters have access to systems that will pull up records of any prescriptions that you have been prescribed over the last several years. For this reason, it is very important to be honest on your application and list all of the medications that you are taking or have taken recently (if the application asks for that). Medigap insurance companies also publish Underwriting Guidelines for agents that list all of the medications that will cause an automatic decline. Certain medications indicate that you have an underlying health condition, so if you take one of these medications, you are not eligible for coverage. Important tip: The underwriter can usually find records of any medication that has been prescribed to you even if you no longer take the medication. Often, we see problems occur when a client goes into their doctor about an issue, and the doctor prescribes a medication. The client thinks “I don’t need that,” and they never take the medication. Just because you choose not to fill the prescription doesn’t mean it’s not in your records. For example, if you mention feeling a bit foggy to your doctor and he prescribes Namenda for memory loss, you will run into a problem. This drug is associated with Alzheimer’s disease and dementia and will cause an automatic decline in most instances. If your doctor talks to you about a medication that you think you don’t need, tell the doctor NOT to prescribe it. This will help to prevent it from getting on your prescription history. Don’t overshare When the underwriter calls you to ask health questions, don’t share anything more than what they ask. Give yes or no answers whenever possible. When you volunteer information, that can sometimes lead you down a rabbit hole that you don’t want to go into. Sometimes applicants want to share that they have recently lost a bunch of weight or they were able to drop all their diabetes medications. While you may view this as positive, underwriters are sometimes wary of recent changes like this as they want you to have had enough time to stabilize on those medications. Going into any application knowing these things about the underwriting process should help both you and your agent to decide whether it makes sense to try applying with a new Medigap company. Danielle K. Roberts is a Medicare insurance expert and co-founder at Boomer Benefits where she and her team help thousands of beneficiaries navigate their Medicare decisions every year.
Medicare is how many U.S. citizens over 65 receive health insurance. Because Medicare works differently from employer-sponsored insurance and private insurance, it can take some time to orient yourself. Medicare offers hospital insurance, medical care insurance, and prescription drug insurance in three plans. For additional coverage or assistance paying for Medicare copayments and deductibles, people can purchase Medicare supplement insurance. This supplemental insurance is often referred to as Medigap. Before enrolling in a Medigap plan, you should understand the cost and benefits of these plans. Here are five essential questions to ask about Medigap: What is Medigap? What does Medigap cover? What is the best Medigap plan? How much do Medigap plans cost? When should I enroll in Medigap? What is Medigap? Medigap offers additional cost-sharing for out-of-pocket expenses incurred by Original Medicare (Parts A, B, and D). This additional cost-sharing is helpful because Original Medicare cost-sharing places a larger burden on policyholders than other private health plans. “What many people don’t realize before enrolling in Medicare is that Medicare is not free and Original Medicare only covers 80 percent of medical expenses – leaving you responsible for the remaining 20 percent of expenses. This form of supplemental coverage is additional insurance to help alleviate the financial burden of covering remaining costs that Medicare won’t cover. For example, Medigap plans are extremely beneficial when it comes to covering costs of chemotherapy and dialysis,” says Danielle K. Roberts, Medicare Supplement Accredited Adviser and Boomer Benefits Cofounder. The additional cost-sharing assistance is also beneficial when people need extensive medical care. “Medigap insurance covers medical expenses Medicare doesn’t cover such as co-pays and deductibles, as well as foreign travel emergencies. The main thing is a major healthcare hospitalization, illness, or injury where the costs are so high that even if Medicare is covering a majority of the costs, the fees are overwhelming. These are “gaps” in Medicare coverage. Admittance into long-term facilities such as nursing homes or hospice can be very large costs,” says Ted Chan of CareDash.com. The health coverage offered by some Medigap plans also include coverage for health services in foreign countries and is great for people who plan on traveling or living abroad during retirement. Do you need Medigap if you have Medicare Advantage? For people with Medicare Advantage plans, Medigap is not available. Medicare Advantage plans work like employer group plans, so they vary company to company and can offer more comprehensive coverage. Expert insight Troy Baccus, Medicare Life Group Owner“The first decision with regard to Medigap is deciding between a Medigap plan and a Medicare Advantage plan. A Medicare Advantage plan will be similar to most employer plans, meaning it'll be an HMO or PPO with co-pays and deductibles. A Medigap plan, on the other hand, has no networks and will work at any hospital that accepts Medicare. For those who decide to go the Medigap route, we recommend choosing a Medigap plan after becoming familiar with the deductibles within each of the plans.” Kumar B. Goel, Lighted Road Insurance President and CEO“Traditional Medicare does not cover everything. For example, it does not cover outpatient prescription drugs or provide dental, vision or hearing benefits (exceptions apply). Medigap Plans do not cover these benefits either. If you are looking for a plan with additional benefits like these, Medicare Advantage may be a better choice for you instead of Medigap.” Back to Question List What does Medigap cover? Medigap currently has 10 plan options: Plan A, Plan B, Plan C, Plan D, Plan F, Plan G, Plan K, Plan L, Plan M, and Plan N. The plans are mostly consistent nationwide. “Except for Massachusetts, Minnesota, or Wisconsin which have their own versions or variations of the plans, the plans offered are the same across states. Whatever the state, you should review carefully to see what suits your needs,” says Chan. All Medigap plans cover the following: Coinsurance and hospital costs (Medicare Part A) up to 365 days once Medicare benefits are used up Coinsurance or copayment (Medicare Part B) First 3 pints of blood Hospice care coinsurance or copayment (Medicare Part A) These benefits are covered fully by Plans A, B, C, D, F, G, and M. Plan K offers 50 percent coverage for Part B coinsurance or copayment, first three pints of blood, and Part A hospice care coinsurance or copayment. Plan L offers 75 percent coverage for those same three benefits. Plan N offers full coverage for all benefits with the exception of copays up to $20 for some office visits and $50 copay for emergency room visits when you’re not admitted to the hospital. All Medigap plans except Plan A offer coverage for the Part A deductible. Plans K and M cover Part A’s deductible at 50 percent. Plan L offers 75 percent coverage for this benefit. The other plans (B, C, D, F, N) cover Part A’s deductible fully. Only Medigap Plans C, D, F, G, M, and N offer coverage for health care during foreign travel. Only Plans C and F offer coverage for Medicare Part B deductible. Since new Medicare enrollees are not able to receive this coverage, Plans C and F are not available to new enrollees. Plans C and F offer full coverage for the Part B deductible. Only Plans F and G offer full coverage for Part B excess charges. An excess charge occurs in cases when a medical provider is allowed to charge more than the Medicare-approved amount. “Some states have rules that override Medicare to the benefit of the consumer. For example, Pennsylvania, Connecticut, Massachusetts, Minnesota, New York, Ohio, Rhode Island and Vermont forbid or restrict Medicare Part B Excess Charges,” says Matthew Claassen, CMT, CEO and Independent Broker of MedigapSeminars.org. Keep your state’s Medicare rules in mind as you choose a Medigap plan. Plans K and L have annual deductibles. None of the other plans have deductibles. People interested in Plan F can choose a Plan F High Deductible Plan option (HDHP) option. Medicare enrollees who choose this option will have an annual deductible. Plan F and C are not available to people enrolling in Medicare for the first time after 2019. See Medicare.gov for further information. Back to Question List What is the best Medigap Plan? The best Medigap plan depends on your circumstances and the kind of coverage you need. Working with a licensed life insurance agent can help you consider all the factors necessary to make an informed decision. Expert tips Danielle K. Roberts, Medicare Supplement Accredited Advisor and Boomer Benefits Cofounder“When deciding which Medigap plan is best for you (A, B, C, D, F, G, K, L, M, or N) you should keep in mind the premium, how often you’ll use your plan, and what kind of coverage you want in case you get diagnosed with a severe illness. Plan F, G, and N are the most popular. When you decide on which plan you want, the only thing you need to look for now is the best premium and average rate increases from each carrier in your area. Since a Medigap plan’s coverage doesn’t change from carrier to carrier, you should just worry about finding the lowest premium with the best average rate increases.” Andrew Vasta, NJ Medicare Brokers LLC Owner“When choosing which Medigap plan, people should consider on average how many times they go to the doctors and the difference in the premium between the plans. Many people choose between Plan G and Plan N. Plan G has no out of pocket costs after the deductible while Plan N has a lower monthly fee but $20 copayment every visit to the doctor.” Matthew Claassen, CMT, CEO and Independent Broker of MedigapSeminars.org“Because a person can apply for a Medicare supplement plan up to six months before it starts coverage, most seniors will start to receive an abundance of cold calls and mailers starting about 7-months before the month they turn 65. This can be overwhelming. Some people turn off their phones or get spam blockers. This is a major issue to people turning 65. Most of these cold callers are from call centers that don’t even employ full time permanent agents. They just cold call and sell. This is not where you are going to get your best advice or even accurate advice. Buyer beware.” Troy Baccus, Medicare Life Group Owner“Make sure to work with an experienced agent who is seasoned in the Medicare insurance industry. A good agent will have complete knowledge about enrollment windows, be able to provide accurate quotes, and ultimately provide a smooth on-boarding process while enrolling in Medigap.” Back to Question List How much do Medigap Plans cost? Several expenses factor into a health plan’s cost: monthly premiums and copays or coinsurance, depending on the policy’s terms. It’s important to consider all of these factors when considering the cost of a Medigap plan. Premium cost Medigap premiums are priced one of three ways: Same rate for everyone, regardless of age Rate based on age when enrolled in plan and remains consistent Rate based on age, but increases with age It’s a good idea to ask how the insurance companies you’re considering determine their rates. It can help you compare premiums for plans across companies. Expert insight Ted Chan, CareDash.com“Typical costs are $200 to $600 depending on the tier of plan. Since the plans are standard (the only difference is cost), it is recommended you shop around, with a focus on reliable providers who you are confident will cleanly service your plan. Reputable insurers offer the plans, and you should recognize the plan being sold (e.g. Aetna, Blue Cross). Don't let a broker push a plan on you.” Andrew Vasta, NJ Medicare Brokers LLC“Medigap policies are standardized so a Plan N with one company is the same exact coverage as a Plan N with another company; however, the monthly premium can be drastically different. Any time someone gets a rate increased they should shop the market to see if they can lower their costs.” Travis Price, Licensed Medicare Supplement Agent ifixmedicare.com“Another great Medigap tip would be to talk to an Independent Medigap Agent. The truth is, insurance companies move in and out of the Medigap market constantly. Furthermore, some companies do not sell direct to consumer and are much less expensive than companies like AARP (United Healthcare) and Blue Cross Blue Shield.” Total cost The total cost of a health plan includes the amount you spend on copayments and coinsurance. These cost-sharing expenses can be harder to estimate and can come up suddenly. Know the total cost of your Medicare Part A and Part B plans, and compare those costs with the Medigap plan’s premium rates. Expert insight Kumar B. Goel, Lighted Road Insurance President and CEO“Medigap Plans typically have higher premiums with minimal cost-sharing compared to Medicare Advantage Plans. This is to be expected since they help pay for Medicare cost-sharing. If you are bothered by deductibles, copays, and coinsurance and would rather pay a consolidated monthly premium, Medigap may be for you. But do the math before deciding.” Back to Question List When should I enroll in Medigap? For guaranteed acceptance, it’s best to enroll at the same time you enroll in Medicare Part B. While there are other circumstances that permit guaranteed issue outside of the window when you enroll in Medicare Part B, it can be a good idea to enroll during your Medigap first open enrollment period. If you delay enrolling, you’ll have to go through an approval process for underwriting. Underwriting is the process insurance companies use to determine the risk of insuring the applicant. It often involves a health questionnaire and can involve a medical exam. In some cases, coverage may be denied because of health circumstances. If you opt for a Medicare Advantage plan instead of Original Medicare, you’ll still be eligible for a guaranteed-issue Medigap open enrollment period. “There are a few other situations where guaranteed issue is applicable. One is if you are on Medicaid Advantage and move, or the Advantage plan stops offering services,” says Chan. There are some exceptions that allow guaranteed acceptance outside of the open enrollment period. “Some states like Connecticut and New York have perpetual Open Enrollment periods. A person can enroll in a Medicare supplement or switch supplements at any time without ever being asked a medical question. Other states have rules that provide an Annual Special Enrollment to switch Medicare supplement plans without underwriting,” says Claassen. Learn more about Medigap guaranteed issue rights. Expert tips Adam Hyers, Hyers and Associates, Inc“For most consumers, the time to get a Medigap (Medicare Supplement) policy is when they first enroll in Medicare Part B. That can happen at age 65, but many people defer their Medicare Part B enrollment because they have qualifying group insurance at work (more than 20 people.) Still, others enroll in Part B before age 65 due to disability. These folks especially want to explore their Medigap options at that time as it may be difficult to get a plan later.” Danielle K. Roberts, Medicare Supplement Accredited Advisor and Boomer Benefits Cofounder“The best time to enroll in a Medigap plan is during your one-time Medigap open enrollment period. This period begins the day your Part B is effective and ends 6 months later. This is considered the best time to enroll in Medigap plans because during this time you don’t have to answer any health questions and therefore, don’t have to worry about getting turned down for coverage. If you miss this time, you will likely have to answer health questions, and can be denied coverage due to preexisting conditions.” Ted Chan, CareDash.com“As a patient advocate, I recommend it enrolling during the Medigap open enrollment period for anyone who has the means and could be overwhelmed by a large, unexpected medical bill. Otherwise, you should reconsider your circumstances and whether Medigap makes sense every open enrollment period. However, getting it right away protects you against developing a pre-existing condition and being denied coverage.” Back to Question List In sum Understanding your Medigap coverage options and your current health situation will help you find a plan that meets your coverage needs. It's also important to keep possible future health concerns in mind as you pick your plan. Keep your financial situation in mind as you evaluate premium costs and the overall costs of a Medigap plan each year. This will help you make smart budget decisions about choosing Medigap coverage. Working with an independent Medicare agent can help you evaluate your options and understand the enrollment rules for Medigap and Medicare. Understanding these rules will help you make informed decisions about Medigap enrollment.