Can I Change My Medigap Plan? A Guide to Switching Policies

Can You Switch Medigap Plans?

Switching Medigap policies is not a right guaranteed by the government unless you are still within your six-month open-enrollment window as stated in your Medicare Plan B or you have rights guaranteed by a state-recognized circumstance, such as certain living situations.

Otherwise, changing Medigap plans is possible but an issue you will have to work out with both your old insurance provider and your intended replacement.

You can change your Medigap policy at any time, but an insurance company can deny you coverage based on your health or other factors.

Situations that can prompt a change in your Medigap plan include:

• You have a policy that is too old.
• You have a new policy (less than six months old) with a pre-existing condition that needs additional coverage.
• You are moving out of the state.
• You are switching to a Medicare Advantage plan.

When Is Medigap Open Enrollment?

The Medigap open-enrollment period refers to the six-month window that begins the month after you turn 65 and sign up for Medicare Part B. You can enroll in any Medigap policy without undergoing medical underwriting during this time, so an insurance company can’t deny you coverage or charge you more based on health conditions.

Outside the enrollment period, insurance companies can deny or increase the price of coverage based on their medical requirements, including pre-existing conditions. If you plan to supplement your Medicare plan with Medigap, then make sure you do it within the open-enrollment period specified on your Medicare card.

Medigap “Free-Look Period”

Once you have a new Medigap plan, you have 30 days to decide if you want to keep it. This is known as the “free-look period.” Despite the name, you will have to pay for both the premiums for that month. The “free” is a bit of a misnomer, since it denotes that you may change policies during this time.

If you decide to apply for a different Medigap plan, then keep the first one until the new one is active. You will have to guarantee on your second application that you will cancel the first policy once the new one goes into effect.

What Is a Guaranteed Issue Right?

A guaranteed issue right means an insurance company cannot refuse you Medigap coverage. You may have this right if you are covered by certain group health plans, are quitting your Medicare Advantage plan within the first year, or the insurance company that offered your plan falsely denies you coverage or commits any illegal action.

The guaranteed issue right allows you to apply for a Medigap policy after your open-enrollment period without the normal restrictions of doing so.

Changing Medigap Policies

It is possible — albeit complicated — to change Medigap policies. It’s confusing, but there are several situations in which you may wonder whether you can, should, or must change your policy.

If You Have an Older Policy

Policies that started before 2010 may have different coverage, and policies from before 1992 may have much higher premiums. You are not required to switch out of your older Medigap plan, but you may want to in order to save money.

Once you buy a new Medigap policy, any outstanding policies have to be canceled within the 30-day free-look period. Once changed, your old policy cannot be repurchased because the circumstances under which you purchased it no longer apply.

If You Have Pre-Existing Conditions

If you have pre-existing conditions, insurance companies cannot deny you Medigap coverage, provided you apply during your open-enrollment period. That said, out-of-pocket costs for these conditions may not be covered for the first six months of your new plan.

You may want to change Medigap policies to better cover these conditions depending on how each provider treats them in its policy. Some providers deny coverage for new pre-existing conditions, defined as those diagnosed within six months of your policy start date. In that case, you may have to wait six months to receive coverage.

If You’re Moving Out of State

If you have Original Medicare, then you can keep your Medigap policy even when moving to another state. Your new financial situation may prompt a change in policy, however, in which case you can switch your plan.

Switching policies in a new state outside of your enrollment period may result in a higher premium as well as a longer application process.

If You’re Switching to Medicare Advantage

Copayments and deductibles accrued through Medicare Advantage are not covered by Medigap. If you’re switching to Advantage, then you will need to cancel your Medigap plan.

If you are already on a Medicare Advantage plan, then it is not legal to buy a new Medigap plan.

How to Switch Medigap Policies

Switching Medigap policies requires different steps depending on your situation. No matter the reason for the switch, you must arrange it with both the old and new providers before canceling your old plan. That means keeping the old plan as you begin the new one and putting on your new application that you will switch off your existing plan after the 30-day free-look period has ended.

For that period, you can have both plans at the same time and decide which coverage works best for you. Just remember that you must pay both premiums during this period.