Navigating the Medicare insurance game proves tricky and complex. With so many options and varying deadlines for each policy, confusion often sets in and overwhelms the average applicant. And with changing regulations, you need quality medical coverage more than ever. What are your options when you miss the Medicare supplemental insurance deadline?
Medigap helps. This supplemental insurance catches some of the medical expenses left to come out of your pocket by original Medicare policies. If you missed your initial enrollment deadline, you may be wondering if you can still take advantage of this supplemental insurance. Fortunately, you have options. Let’s take a look at what Medigap is and what to do if you missed the deadline.
Medigap offers additional coverage to your original Medicare policy. In short, you must be Medicare eligible and a recipient of it. The supplemental insurance, Medigap, brings peace of mind by helping pay deductibles, copayments and coinsurance, not covered by your original policy.
Keep in mind: Medigap fails as a cure-all. This insurance does not cover vision care or eyeglasses, dental care, hearing aids, prescriptions, long-term care or private nursing. Also, some insurance plans, such as the Medicare Advantage Plan, do not partner with Medigap.
However, Medigap policies provide extra coverage for hospital and doctor services which otherwise drain finances. You get a choice in the level of coverage you want and pay a monthly premium based on the plan chosen. Purchased through private insurance companies, the premiums vary.
Initial open enrollment for Medigap runs for six months from the first day of your birth month, in the year you turn 65. For instance, if you turn 65 years old on October 20, 2018, your enrollment period runs from October 1, 2018 through April 1, 2019. But, what if you realize this period has passed?
All is not lost if you missed the deadline. Check out the following circumstances when you might apply for Medigap after the initial open enrollment deadline.
Some applicants are guaranteed Medigap coverage. If you fall into one of the following categories, you need not wait for an enrollment period to apply:
– Your employer-sponsored supplement to Medicare ends.
– You lose eligibility for an employer’s plan due to divorce or death of the member or the company reduces benefits for any reason.
– Your Medicare Advantage Plan raises premiums or copayments by 15 percent, reduces benefits or the plan ends.
When Medigap applications follow continuous creditable coverage, you cannot be denied based on a pre-existing condition. In the case of pre-existing conditions, Medigap becomes more difficult to approve outside the initial enrollment period. Your application can be denied.
However, knowledgeable insurance agents help you choose and obtain the Medigap plan which fits your needs, even if you miss the enrollment period. Medigap policies may accept your application but refuse to cover pre-existing conditions for up to six months. After that period, they must cover the condition.
If your enrollment with Medicare Advantage made you ineligible for a Medigap policy, switching to Medigap opens a door after the enrollment period. The best times to make the change are:
– Special enrollment periods
– The Annual Election period (from October 7 through December 15)
– And, the Medicare Advantage Disenrollment period (January 1 through February 14)
Eligibility requirements must be met. And, keeping your Medicare Advantage until approved for Medigap proves wise. Again, an expert helps identify the ideal times to apply and the best companies to work with while navigating deadlines and details.
Several Medigap plans exist. Several insurance companies offer the policies. Should you need to change plans or insurance companies to one which better meets your financial and health needs, you may do so outside the open enrollment period.
Most states require a new application and a set of medical questions. This raises the chance of being denied on pre-existing conditions. Several states allow switching with no medical review. A financial penalty may also be involved. Seeking knowledgeable council helps you understand where your state falls on these issues.
Determining the best plan with the least amount of red tape, deadlines, and fees may overwhelm you. Furthermore, private insurance companies set prices and determine rules for eligibility which complicates the shopping process.
You are not alone. Seeking the help of knowledgeable insurance agents ensures that you do not miss deadlines or open enrollment periods. It also sets you on a path to finding the best Medigap option for you both medically and financially, even outside the enrollment period.
So, can you still qualify for Medicare Supplemental Insurance? The answer: Likely, yes.
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Category: Medicare Supplements