Changing Your Medicare Supplement

Fill out the Customized Quote form to see if you can change your Medicare Supplement

What Time Of Year Can I Change Medicare Supplement Plans?

Most people associate change plans with the Medicare Annual Enrollment Period from October 15 through December 7 of each year.  This has nothing to do with changing Medicare Supplement (Medigap) plans.  It only applies to Medicare Advantage and Medicare Part D prescription plans.  Simply put, you can apply for another Medicare Supplement at any time of the year.  The kicker is that you can apply, but it doesn’t mean you’ll be approved.

What Is A “Standardized” Medicare Supplement?

Medicare Supplements were standardized by Medicare in 1992.  Currently, there are 11 different standardized plans in 47 states.  They are plans A, B, C, F, High Deductible F, G, High Deductible G, K, L, M, and N.  If you weren’t eligible for Medicare Part A or B before January 1, 2020, you can’t buy an F or C plan, including the High Deductible version of F.

The standardization of Medigap plans has made it simpler for shoppers to compare, and you don’t need to compare what each covers if you are shopping for the same lettered plan.  So if you have a plan G now, rest assured, if you purchase a plan G with another company, it will give you the same coverage.

A few companies now offer an enhanced variation of the Standardized G called “Innovative” plans, including additional benefits like preventive care and some dental/vision/hearing coverage.  Sometimes, these plans cost more or limit your Plan G benefits, so ensure you get a detailed explanation before making the change.

The three states that don’t use the “Standardized Plans” are Wisconsin, Minnesota, and Massachusetts. They have their versions, but other than an extra benefit for preventive care, they end up being equivalent to the other lettered plans, and sometimes a little better.

A Medicare Supplement with the same letter has IDENTICAL coverage regardless of the company, unless it’s an Innovative plan.  Some compare this to a commodity, but there’s more to it.  Price isn’t the only thing you should consider when choosing a new company.  So why would anyone change other than the price?  Here’s what you need to know.

• Experience – The number of years the company has been offering Medicare Supplement policies
• Rate Increase History – How much did the rates increase (not due to age) for the same letter plan in your zip code
• Claims Ratio -How much the company collects in premiums versus paid out in claims

Can I Change From One Medicare Supplement To Another Without Underwriting?

Birthday Rule, Anniversary Rule, and Year-Round Enrollment

You can change your Medicare Supplement at any time of year if you pass medical underwriting in any state.  If you can’t pass,  you might be able to get a new plan without going through medical underwriting if you live in one of the states with an exception rule.  These special guaranteed acceptance rules allow you to choose new coverage within a limited time every year, around your birthday or another specific time.

The rules are slightly different in each state and have changed over time.  Currently, there are 10 states with Birthday Rules, including California, Idaho, Illinois,  Kentucky, Louisiana, Maryland, Missouri, Nevada, Oregon and Utah.  Connecticut, Maine, New York, Oklahoma, Vermont, and Washington allow you to change all year round.  If you live in Massachusetts, you can change it in February or March yearly.

You must pass medical underwriting if you don’t live in a state with a Birthday, Anniversary, or Yearly rule.  Medical underwriting determines whether you pass the medical qualifications and includes passing the health questions on an application.  You’ll need to answer medical questions on the application, and the insurance company will get informational reports regarding your prescriptions and medical history.

What Are The Health Questions On A Medicare Supplement Application?

 The example below is just a sample and does not represent the questions every company asks, but these are the most common.

1. Are you currently hospitalized or in a nursing home or assisted living facility, or are you bedridden or confined to a wheelchair, or require the assistance of motorized mobility aid, or have you had any amputation caused by disease?

2. Are you currently receiving any occupational, speech, or physical therapy, or are you currently receiving any services from a home healthcare agency?

3. Have you been medically diagnosed with, or treated at any time for Emphysema, Chronic Obstructive Pulmonary Disease (COPD), any other chronic pulmonary disorders (not including asthma), or any medical condition requiring the use of oxygen?

4. Have you had, been medically diagnosed with, or treated at any time for Parkinson’s Disease, Arthritis that restricts mobility, Systemic Lupus, Myasthenia Gravis, Multiple or Amyotrophic Lateral Sclerosis, Scleroderma, Chronic kidney disease (stage 3-5), Chronic Hepatitis, Cirrhosis of the liver, or renal failure requiring dialysis?

5. Have you been diagnosed with Alzheimer’s Disease, Dementia, Muscular Dystrophy, or any other cognitive disorder?

6. Have you been diagnosed with or treated for Acquired Immune Deficiency Syndrome (AIDS) or AIDS Related Complex (ARC) or human immunodeficiency virus (HIV) infection?

7. If you have diabetes or take prescription medication to control your blood sugar, have you been medically diagnosed with or treated for any of the following conditions: peripheral vascular disease, peripheral venous thrombotic disease, peripheral artery disease, kidney failure, kidney disease, stroke, transient ischemic attack (TIA), congestive heart failure, or any heart disorder?

8. If you have diabetes or take prescription medication to control your blood sugar, do you take three (3) or more medications (oral or injections) to control your blood sugar?

9. If you have diabetes or take prescription medication to control your blood sugar, do you take four (4) or more medications to control your high blood pressure?

10. Have you ever had a medical professional advise you to take more than 50 units of insulin daily or have you ever required more than 50 units of insulin daily for diabetes or to control your blood sugar?

11. Within the past two (2) years have you had or been treated for or been advised by a physician to have treatment for internal cancer (examples include but are not limited to liver, breast or lung cancer, etc.), malignant melanoma, lymphoma, leukemia, Hodgkin’s disease, alcoholism or drug abuse, or have you been advised to have a joint replacement?

12. Within the past two (2) years have you had or been treated for or been advised by a physician to have treatment for heart attack, cardiac angioplasty, implantation of a pacemaker, bypass surgery, stent placement or replacement, vascular angioplasty, endarterectomy, stroke or transient ischemic attack (TIA)?

13. Have you been advised by a physician to have surgery (including cataract or joint replacement surgery), medical tests, infusions, treatment or therapy that has not been performed?

14. Have you been hospital confined three (3) or more times in the last two (2) years?
15. Have you been medically diagnosed with, or treated at any time for, an organ transplant, been advised by a physician to have an organ transplant (excluding cornea transplants), or had a cardiac defibrillator implanted?

16. Within the past two (2) years have you had or been treated for or been advised by a physician to have treatment for angina, heart attack, heart disease, heart valve disease, coronary artery disease, aortic or cardiac aneurysm, cardiomyopathy, carotid artery disease (not including high blood pressure), congestive heart failure, atrial fibrillation, peripheral vascular disease, peripheral venous thrombotic disease, enlarged heart, or other heart rhythm disorder?

17. Within the past two (2) years, have you been treated for degenerative bone disease, rheumatoid arthritis, or spinal stenosis?

18. Within the past two (2) years, have you had or been treated for or been advised by a physician to have treatment for a mental or nervous disorder requiring treatment by a psychiatrist?

19. Are you currently receiving, or have you been advised to receive, injections in a physician’s office?

Should I Change My Medicare Supplement?

The simple answer is YES!  The only way to keep the cost down is to change.  Once your premiums are more than around 25%, it’s time to look around and compare.  Our independant agents can help determine if your eligible to change and when.

Changing your Medicare Supplement can be a daunting task.  The average person shouldn’t have to know all the rules and regulations. Most need to talk with a Medicare expert.  We’ll do that free of charge without commitment or pressure.