Does all Medicare private coverage have open enrollment periods?

Does all Medicare private coverage have open enrollment periods?

Medicare Advantage and Medicare Prescription Drug Plans Part D do have annual open enrollment periods.

Medicare Supplement Insurance (Medigap) does not have an open enrollment period.

Medicare Advantage and Medicare Part D

The open enrollment period begins on October 15 and runs through December 7. Coverage begins on the following January 1. This period is for anyone who would like to enroll in a different plan being offered in your area of residence. Generally, plans to do not exclude pre-existing conditions. The only exception is end-stage renal failure. Someone with this diagnosis can switch plans only if the current plan is discontinued.

Medigap

With no open enrollment period, individuals can enroll at any time of the year. However, there is a disadvantage for those individuals who do not enroll during the initial period of six months. Premiums for some plans are based on an enrollee's age. Also, enrollees with pre-existing conditions may end up paying more out of pocket, as the plans can use these conditions to determine premiums or even eligibility.

The following states have Medigap regulations:

Massachusetts, New York,  and Connecticut

Pre-existing conditions are never used to determine eligibility or premiums.

California

California offers 30 days following an enrollee's birthday to switch plans of similar value. Pre-existing conditions cannot be used to determine eligibility or premium during this window of time.

Missouri

Missouri offers 30 days before an enrollee's policy expiration date to switch plans of the same letter. Pre-existing conditions cannot be used to determine eligibility or premium during this window of time.

Maine

Insurers who offer Medigap must offer at least one plan for at least one month each year that does not use pre-existing conditions to determine eligibility or premium.

Special Enrollment Periods

Some special circumstances exist in which Medigap plans are offered regardless of pre-existing conditions. These include the following:

  • An individual moves out of the plan area.
  • A plan has been discontinued.
  • An individual who is using Medicare Advantage which includes one trial year, has decided to switch back to Medicare Part A and Part B with Medigap.*


*If an individual begins with Medigap, switches to Medicare Advantage, and switches to Medigap again, he or she must go back to the same Medigap plan if it is available.

Most Popular Medigap Options

Because pre-existing conditions can be considered with Medigap, most people choose the most sweeping plans. Consider the following 2016 statistics.

  • 55% of Medigap enrollees used Plan F, the most extensive plan offered.
  • 10% of Medigap enrollees used Plan G, up from 6% in 2013.
  • 7% of Medigap enrollees used Plan C, down from 11% in 2013.


Beginning in 2020, plans that include payment for the Part B deductible will no longer be sold due to the Medicare Access and CHIP Reauthorization Act of 2015. This includes Plans F and C. After Plan F, Plan G coverage is the most extensive.

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Does all Medicare private coverage have open enrollment periods?