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Before You Buy a Supplemental Health Insurance Policy

Before buying a senior supplemental health insurance policy, you must have Medicare Part A and B (there are rare exceptions to this rule). You will continue paying your Medicare Part B premium in addition to the premium for your Medigap policy.

All new Medigap policies are guaranteed renewable, which means that your supplemental health insurance provider must provide coverage benefits as long as you continue to pay your premium.

The Best Time to Buy a Medigap Policy

Your Open Enrollment Period for seniors is the six-month stretch after you and partner are both 65 and enrolled in Medicare Part B. The Open Enrollment Period is the ideal time to buy a Medigap supplemental health insurance policy. During this time, medical insurance cannot use medical underwriting to determine your Medigap eligibility. This means:

  • It can't deny you any Medigap policy it sells
  • It can't delay the start of your health insurance coverage (except in certain cases - see below)
  • It can't increase the price of your Medigap policy based on pre-existing health conditions

Although a senior supplemental health insurance provider can't make you wait to receive general coverage, it may be able to delay the coverage of pre-existing health problems. This delay period, called a "pre-existing condition waiting period", may last for up to six months.

If you buy your senior supplemental health insurance policy during your Open Enrollment Period, and if you recently had creditable coverage (certain types of coverage that can short circuit the pre-existing condition waiting period), the insurer must shorten or do away with the waiting period. Several types of health care coverage are considered as creditable coverage for Medigap, but they only apply if you haven't had breaks in coverage. A break is considered 63 consecutive days without health insurance.

Supplemental health insurance companies cannot delay coverage of pre-existing conditions if you buy a Medigap policy when you have guaranteed issue rights. Also known as "Medigap protections", guaranteed issue rights are rights granted to you which say that insurers must by law sell you a supplemental health insurance policy.

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