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to qualify for a Medigap plan, you must be enrolled in Original Medicare (A and B)

How Do I Qualify for a Medicare Supplement Plan?

Medicare Supplement plans, also known as Medigap, can help cover expenses not covered by Medicare Part A and Medicare Part B. However, to enroll in a plan, you must qualify for one. In this post, we’ll examine the eligibility requirements for Medicare Supplement plans.

Original Medicare

To be eligible for Medicare Supplement plans, you must be enrolled in Medicare Part A and Medicare Part B as the supplement plans fill in the gaps of Original Medicare. Keep in mind that Medigap plans are not meant to serve as primary health insurance as they only help cover the out-of-pocket costs that may not be covered by Original Medicare, which will serve as your primary insurance (depending on if you have other health insurance or not). 

For individuals who are under 65 and have Original Medicare because of a disability, Amyotrophic Lateral Sclerosis, or End-Stage Renal Disease, a supplement plan may not be acquired. Insurance companies are not allowed to sell Medigap plans to anyone under the age of 65, so even if you do qualify for Original Medicare when under 65, you will not be able to purchase a supplement plan until you meet the age requirement. However, some states have different guidelines and do require insurance companies to sell Medigap to anyone under 65, but keep in mind that you may pay more if this is the case.

Medigap Open Enrollment Period

The Medigap Open Enrollment period is usually the period when Medicare beneficiaries who have turned 65 and have Part B coverage can enroll for a Medicare Supplement plan. During this six-month period, beneficiaries can purchase a Medicare Supplement plan without being denied coverage because of health issues. 

After the Medigap Open Enrollment Period, Medicare beneficiaries can apply for a supplement plan but may undergo underwriting. The supplement plan provider may also charge higher rates if the enrollee has an existing health issue. 

Medicare Advantage

If you have a Medicare Advantage Plan, you will not be able to have a Medicare Supplement plan as the two do not work together. This is because Medicare Advantage serves as an alternative to Original Medicare, while Medicare Supplements only fill the gaps in Original Medicare coverage. All in all, you will have to choose one over the other. 

Proinsurance Hawaii has a team of insurance professionals ready to help you find answers to your questions. Contact us now to learn how you can get started with a Medicare Supplement Insurance policy.