I missed my Medigap window by a few months and now no one will cover me without underwriting. Why isn't this rule more well known?
Answered by 10 licensed agents
The first thing that comes to mind is that you probably did not meet with a long-time Medicare professional agent who knows the ins & outs of its very quirky rules. In my opinion, enrolling with Medicare yourself online means that you may be bypassing the rules concerning the different periods during the year when one can enroll AND make changes.
The only thing for you to do at this point is to enroll with a Medicare Advantage plan temporarily (you HAVE the right to do this at anytime since you've never enrolled before by picking up Medicare Part B with a monthly premium). Then, when the Open Enrollment begins on October 15th thru Dec. 7th (to become effective on Jan. 1st of the following year), you have what is known as "a trial right", meaning since you have your very 1st Medicare plan for less that 12 months, you will be able to apply for a Medigap (a.k.a., Med. Supp.) without having to answer any medical questions concerning pre-existing conditions.
Using any online information only yields the more well-known tenets of Medicare. The best advice I could ever give anyone regarding THE most important aspect of your life: HEALTH, is to be certain to get a 2nd & even 3rd opinion from an independent rep who is also known as a broker. However, in using a "Captive Agent": one who only has allegiance to one insurance firm, is foolhardy since all companies who offer Medicare-compliant Advantage plans can vary the rules to a certain extent. Though I truly hope that most agents are honest/reliable and can cover the gamut of the regulations, as an instructor myself, I will deliberately "over"-emphasize the more important areas/rules to all of my clients. Good luck and if needed, call 1-800-MEDICARE so that the person on the other end who's trained for this, confirms what a trial right means.
Always best to call a broker who gives you all your options before either turning 65 or leaving an employer plan. Right broker will tell you the timeframes you’re looking at. But please note the state of NY is different. In NY it’s always Open Enrollment meaning you won’t miss you’re window of opportunity there and insurers cannot deny you coverage
This is another example of having a competent broker that ONLY does Medicare and is INDEPENDENT. Your broker should have explained the rules and deadlines to you so you would not miss your opportunity. The reason Medicare recipients should have a broker that only does Medicare is simple....you can't be an expert at everything, there just isn't enough hours in the day.
Most people don't know there's a 6 month Medigap enrollment window that starts after you get Part B. If you miss that window, the insurance company can ask health questions and deny coverage. However, choosing the right agent is a great way to make sure you stay informed and educated of insurance matters that pertain to your health condition and life circumstances.
You deserve to know your opportunities and liabilities when it comes to timing of enrollment. Too many only find out about deadlines or penalties after it’s too late. Don’t let this happen to you or those you care about. Let’s talk!
Every year CMS publishes a Publicly available (Online) guide called "Medicare and You". It explains in great detail the Process of how Medicare works. It also highlights the rights and responsibilities of Medicare Beneficiaries. I would encourage you to work with your agent to get more information, the key is taking control of your healthcare by seeking the answers.
There are a lot of Medicare/Insurance rules that should be more well known & this is definitely one of them. We have to put people through underwriting all the time for different reasons. This is one of the reasons I license with so many different companies... If one declines, try another. Depending on health issues, there's usually a company out there.
If you would like to give me a call, I can advise for your specific circumstances. And don't worry, no pressure. I'm happy to answer questions & give guidance with no strings attached.
You can apply for a Medigap (Medicare Supplement) plan with no medical underwriting 6 months prior to your Medicare effective date and 6 months after. After 6 months you would need to go through medical underwriting. Exception would be if you are after age 65 and coming off group health insurance. There are a few other exceptions that I can answer by contracting me.
You're not alone—most people don’t realize there’s a one-time 6-month Medigap enrollment window that starts when you first get Part B. After that, insurance companies can ask health questions and even deny coverage. It’s one of the most misunderstood parts of Medicare, and honestly, it should be talked about more. That’s why I make sure my clients know their timing options early on.