If you enroll in a Medigap plan within 6 months of enrolling in Original Medicare Part B and are over age 65, Medigap insurers cannot use pre-existing medical conditions to deny or decide on your coverage.

Medicare supplement insurance, also known as Medigap plans, can help with the out-of-pocket costs related to Original Medicare.

During the 6-month Medigap open enrollment period, you can buy any plan sold in your state, regardless of your health status.

You cannot use Medigap plans alongside Medicare Advantage.

The Medigap open enrollment period is a one-time period that does not repeat yearly. It begins the month you turn 65 and enroll in Original Medicare Part B and continues for the following 5 months, making a total period of 6 months.

During this time, you can enroll in any Medigap plan available in your state, and the insurance company offering the plan cannot consider your medical history or current health status when deciding on your application.

After the Medigap open enrollment period ends, you may be unable to purchase a Medigap plan. If you can, you may pay significantly more for the policy.

Insurers can also then use your medical history to decide whether you meet the plan’s health requirements. They can deny coverage based on the information you provide.

In certain situations, you can buy a Medigap policy outside of the Medigap open enrollment period, and where an insurer cannot deny you a Medigap plan. This is due to guaranteed issue rights, also called Medigap protections.

If you have a Medicare Advantage plan, you have a guaranteed issue right in the following instances:

  • your plan provider is no longer participating in Medicare
  • your plan provider will no longer be participating in your service
  • you move out of your plans service area
  • you leave a Medicare Advantage or Medigap plan because the insurer has not followed Medicare rules

If you currently have Original Medicare alongside a group plan through your employer or a union plan that pays your medical bills after Medicare pays and that plan is ending, you have a guaranteed issue right.

You also have guaranteed issue rights if you have a Medicare Select plan and are moving away from the plan’s service area, or if you left a Medigap plan to join a Medicare Select plan for the first time, have been in the plan for under a year, but want to switch back.

If a Medigap plan provider is declared bankrupt and you lose your coverage, or if your coverage ends for reasons beyond your control, you will maintain your guaranteed issue rights.

To establish Medigap eligibility outside of Medigap open enrollment, private insurance companies typically ask questions about your:

  • medical history
  • medications
  • height
  • weight
  • hospitalization or used a skilled nursing facility history
  • planned medical procedures

In some instances, they may contact you by telephone to clarify your answers to the questions.

You can check with your state insurance department to see if your state has additional rules surrounding buying a Medigap plan outside of the Medigap open enrollment period.

If you are age 65 and have only just enrolled in Original Medicare Part B, you could have a 6-month period to enroll in a Medigap plan without having to consider Medigap underwriting.

During this enrollment period, Medigap plan providers cannot use your medical history or current health status to decide your plan eligibility.