Key Takeaways

• Your eligibility for guaranteed Medigap coverage without medical underwriting is tied to strict enrollment windows—miss them and you could be denied or charged more.

• While Medigap plans offer long-term stability, the timing of your enrollment directly affects your future premiums and access to coverage.

The Promise of Medigap Stability

When you’re enrolled in Medicare, the idea of a Medigap plan—also known as a Medicare Supplement plan—can be a financial lifesaver. These plans are designed to cover out-of-pocket costs not paid by Original Medicare, such as deductibles, coinsurance, and copayments. If you’re someone who values predictability and stability, Medigap offers a way to plan your healthcare expenses with fewer surprises. But all that peace of mind depends on one crucial factor: timing.

Understanding Your Medigap Open Enrollment Period

The most important deadline when it comes to Medigap is your Medigap Open Enrollment Period. This six-month window begins the month you turn 65 and are enrolled in Medicare Part B. During this time:

• You have a guaranteed right to buy any Medigap plan sold in your state.

• Insurance companies can’t deny you coverage.

• You won’t be charged more due to pre-existing health conditions.

If you miss this window, you may face medical underwriting, higher premiums, or even denial of coverage depending on your health.

What If You’re Still Working at 65?

Many people delay Medicare Part B because they’re still working and have employer coverage. In that case, your Medigap Open Enrollment Period is postponed until you enroll in Part B. Your six-month window starts then—not before. But don’t confuse this with delaying too long. Once your employer coverage ends, act fast. Missing your special enrollment rights can eliminate your guaranteed access to a Medigap policy.

Guaranteed Issue Rights Aren’t Always Guaranteed

There are special situations where you may be eligible to buy a Medigap plan outside your Open Enrollment Period without being denied. These are called guaranteed issue rights and they apply in cases such as:

• Your current Medicare Advantage plan leaves Medicare or you move out of its service area.

• You lose coverage through no fault of your own.

• You drop a Medigap plan to try a Medicare Advantage plan for the first time and return within 12 months.

But these rights come with strict timeframes—often 63 days from the end of your previous coverage. Miss the deadline and your rights disappear.

The Cost of Missing Your Enrollment Window

If you apply for a Medigap plan after your Open Enrollment Period and without a guaranteed issue right, you’ll face medical underwriting. That means:

• You may be asked health questions.

• You could be charged more—or denied—based on your health status.

• Chronic conditions or recent hospitalizations can dramatically affect your eligibility.

This risk increases as you get older, especially in your late 60s or 70s when health issues are more likely to emerge.

State-Specific Rules That May Help—or Hurt

Some states have laws that go beyond federal protections. A few offer:

• Continuous or annual guaranteed issue rights.

• Birthday rules allowing plan changes without underwriting.

• Medigap protections for people under age 65 with disabilities.

But these are exceptions, not the rule. In most states, if you miss your initial window, the odds are not in your favor.

Always check your state’s Medigap regulations before assuming you can switch plans without consequences.

Can You Switch Medigap Plans Later?

Yes—but switching isn’t always easy. After your initial enrollment, there’s no annual window that guarantees plan switching like Medicare Advantage or Part D. You can apply at any time, but you’re usually subject to underwriting unless you qualify for a special exception.

That said, switching may make sense if:

• Your premiums have increased significantly.

• You want a plan with better benefits or lower costs.

• Your health has improved since your original enrollment.

Before applying, be sure the new insurer accepts your application and offers the policy before you cancel your current one. Losing your existing plan without guaranteed acceptance into a new one could leave you uncovered.

Pre-Existing Conditions and Waiting Periods

If you apply for a Medigap policy outside your Open Enrollment Period, some insurers may impose a pre-existing condition waiting period of up to six months. This means they can delay covering costs related to a condition you were treated for within the six months before applying.

This waiting period can’t be imposed if:

• You’re in your Open Enrollment Period.

• You had at least six months of prior creditable coverage with no break longer than 63 days.

To avoid unnecessary delays in coverage, maintain continuous insurance and keep records of prior coverage.

Comparing Medigap to Medicare Advantage Timing

Medicare Advantage plans operate on a more structured calendar. Each year, the Annual Enrollment Period from October 15 to December 7 allows you to join, drop, or switch plans. Medigap, by contrast, doesn’t follow this annual rhythm.

This is a point of confusion. Many people assume they can review Medigap options every fall just like Advantage or Part D plans—but that’s not how it works. Unless you qualify for a special enrollment right, you can’t freely move between Medigap plans each year.

Why Timing Affects Premium Stability

One reason people gravitate toward Medigap is the predictable cost-sharing it provides. However, timing affects what you’ll pay.

• Enroll during Open Enrollment: You’ll get the lowest rates available to people your age in your area, regardless of your health.

• Enroll later: Your premiums may be higher due to underwriting or your health history.

Locking in your Medigap plan early helps you maintain a steady premium over time. Some plans even allow you to keep your initial rate class indefinitely if you maintain coverage without lapses.

The Role of Medicare SELECT Plans

Medicare SELECT is a type of Medigap plan with a restricted network. These plans require you to use certain hospitals and, in some cases, doctors to be eligible for full benefits.

If you decide to switch from a SELECT plan to a standard Medigap policy, your ability to do so without underwriting often depends on timing. Some states give you a guaranteed issue right if you switch within 12 months of joining the SELECT plan—but after that, underwriting rules usually apply.

What to Do If You’ve Missed the Window

If you’ve already missed your Open Enrollment Period and don’t have a guaranteed issue right, don’t panic—but don’t wait either. Take the following steps:

• Contact insurers directly to see if they’ll accept your application.

• Compare underwriting policies—some are more lenient than others.

• Consider working with a licensed agent who understands the rules in your state.

Remember, the longer you wait, the more likely your health history will impact your eligibility and cost.

Why Early Planning Pays Off

Medigap planning shouldn’t be left until the last minute. If you’re turning 65 this year or losing employer coverage, start your research at least 3 to 6 months in advance. This allows time to:

• Understand your Medigap Open Enrollment timeline.

• Compare plan types and costs.

• Confirm your eligibility for guaranteed rights.

• Line up any documentation needed for prior coverage.

It’s easier to make confident decisions with a clear plan in place than to rush under pressure.

Secure Your Coverage Before It’s Too Late

Medigap plans can provide unmatched financial predictability in retirement, but that stability hinges on timing. Missing critical deadlines may limit your options or cost you more down the road. Whether you’re approaching Medicare eligibility or evaluating your next move, timing should be at the top of your list.

For help understanding your deadlines and rights, speak with a licensed agent listed on this website. They can walk you through your specific situation and ensure you don’t miss out on important protections.