Preexisting Conditions and Medigap

A: Many people don’t realize that even though preexisting conditions can’t affect your ability to get other types of health insurance, such as Medicare, the rules are very different for Medicare Supplement Insurance, or Medigap.

Medigap plans are sold by private companies and can help pay some of the health care costs original Medicare doesn’t cover, such as copayments and deductibles.

You can pick any Medigap plan available in your area within six months after you initially sign up for Medicare Part B. But after that, Medigap insurers in almost all states can reject you or charge more based on your health.

This can make it difficult if you’d like to switch to another insurer with better Medigap rates or if you had a Medicare Advantage plan for more than a year and want traditional Medicare and a Medigap policy instead.

There are a few exceptions. Four states — Connecticut, Maine, Massachusetts, and New York — have special rules that let residents switch Medigap plans regardless of preexisting conditions.

Other states permit you to change plans at certain times. For example, Californians may select a different plan that has the same or fewer benefits if they make the choice within 30 days after their birthday each year. You may also buy a policy without concern about preexisting conditions if you move out of your Medicare Advantage plan’s service area or change your mind within 12 months of signing up for Medicare Advantage at age 65. For more information see Medicare.gov.

(For more information about your state’s rules, see your state insurance department website. You can find links at https://content.naic.org/state-insurance-departments.)

Be aware, your insurer may let you switch to a less-comprehensive policy regardless of your health.

And if you’re healthy, you may still be able to qualify for a new Medigap policy, especially if you’re in your mid-to-late 60s. You don’t need to wait until any specific time of year to apply for a new Medigap policy because there is no annual open-enrollment period.

Kimberly Lankford is a contributing writer at Kiplinger Personal Finance magazine. For more on this and similar money topics, visit Kiplinger.com.

©2024 The Kiplinger Washington Editors, Inc. Distributed by Tribune Content Agency, LLC.

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