While Medicare Supplement plans can be purchased year-round — meaning your clients can switch at any time — insurance companies may require health questions to be answered to determine eligibility. When clients initially enroll in Medicare — during their six-month initial enrollment period around their 65th birthday — they have a guaranteed issue right, meaning insurers cannot deny coverage or charge extra based on their health. States have the flexibility to institute consumer protections for Medigap that go beyond federal standards. To see if your state offers guaranteed-issue protections for your clients, call Medicare BackOffice® at 1.877.385.8083.
Open enrollment, which is Oct. 15 through Dec. 7, each year is when people with Medicare Advantage and Medicare Part D Prescription Drug plans can change their plan for the next year. While Medigap policy holders can switch year-round, open enrollment still can be a great time to review their existing coverage, because a review can identify coverage changes, or premium or deductible changes that could be costly. When your clients call Medicare BackOffice, the Licensed Insurance Agents will not pressure them to change plans, whether they have Medicare Advantage, Part D, Medicare Supplement or any combination. If they have Medicare Supplement, the agent will explain that switching Medigap plans can trigger underwriting. However, if your client is relatively healthy, he or she may not have any issues with switching plans, meaning they could potentially get a plan that saves them money or provides better coverage.
The Kaiser Family Foundation compiled a list of potential medical conditions for which a Medigap insurer may deny coverage without guaranteed issue protections. It includes stroke, mental/nervous disorders, heart disease, congestive heart failure and Alzheimer's disease and other dementias, for example.
