Medicare Supplement Open Enrollment Period (MSOEP)

Summary: The Medicare Supplement Open Enrollment Period is a once-in-a-lifetime period in which you can enroll in a Medicare Supplement plan without medical underwriting. This period begins when your Medicare Part B coverage goes into effect and lasts for six months. In this article, we’ll explain why enrolling in a plan during your Medicare Supplement Open Enrollment Period is important and what happens if you miss it. Estimated Read Time: 6 min

What is the Medicare Supplement Open Enrollment Period

The Medicare Supplement Open Enrollment Period is a six-month period in which you can enroll in a Medicare Supplement plan without medical underwriting. Also called the Medigap Open Enrollment Period, this enrollment period only occurs once in a lifetime for most individuals.

Enrolling in coverage during the Medicare Supplement Open Enrollment Period is beneficial because:

• You can enroll in any Medicare Supplement plan available in your state
• You can enroll in a policy regardless of whether you have pre-existing conditions
• You generally have more choices among plans and better prices
• You can shorten or avoid waiting periods for pre-existing conditions (if your Medigap policy is replacing creditable coverage, such as employer coverage).

Missing your Medigap Open Enrollment Period can result in fewer options for Medigap policies, and higher premiums down the road. This is due to medical underwriting. Unless you qualify for guaranteed issue rights, or your state has a unique circumstance, such as a Medigap birthday rule, your Medicare Supplement Open Enrollment Period is the only chance you’ll get for enrolling in a Medicare Supplement policy without medical underwriting.

When is the Medicare Supplement Open Enrollment Period?

The Medicare Supplement Open Enrollment Period is unique for each Medicare beneficiary.

The Medicare Supplement Open Enrollment Period begins on your Medicare Part B effective date. For many, this will be the first day of the month you turn 65.

Your Medicare Supplement Open Enrollment Period will then run for six months. During this time, federal law permits you to buy any Medicare Supplement plan you want that is available in your state. You cannot be denied a Medigap policy due to existing or pre-existing health problems.

Your Medicare Supplement Open Enrollment Period will end on the last day of the sixth month following the start of your Part B benefits. Let’s look at an example:

You’re turning 65 in May. You decide to sign up for Medicare Part A and Part B in April, so your coverage will begin on May 1st. Since your Medicare Part B coverage begins on May 1st, your Medicare Supplement Open Enrollment Period will also begin on May 1st. Your Medigap Open Enrollment will last for six months and end on October 31st.

It is important to know that you do not always have to wait until the month of your 65th birthday to utilize the Medicare Supplement Open Enrollment Period. Many Medicare Supplement carriers will allow beneficiaries to lock in their Medigap plan up to six months before their Medicare Part B start date.

In this case, the insurance company still treats these additional six months as a part of your Medicare Supplement Open Enrollment Period and will enroll you in the plan without underwriting health questions.

When you enroll in a Medicare Supplement Plan during your Med Supp Open Enrollment Period, your coverage will generally begin the first of the month after you apply.

How the Pre-Existing Condition Waiting Period Works With Medigap Open Enrollment

Though Medicare Supplement Plan providers cannot deny you coverage due to pre-existing conditions during the Medicare Supplement Open Enrollment Period, you may still have a waiting period for pre-existing conditions. So, what does that mean?

Insurance companies offering Medigap plans may refuse to cover out-of-pocket costs for treatments related to pre-existing health conditions for up to six months after your policy begins. This is called a “pre-existing condition waiting period”. This waiting period can only be applied to pre-existing conditions that were treated or diagnosed within 6 months before your Medicare Supplement coverage starts.

If you enroll in a Medicare Supplement plan during your Medicare Supplement Open Enrollment Period, you may be able to reduce or eliminate the pre-existing condition waiting period. If you had at least six continuous months of creditable coverage prior to enrolling in a Medicare Supplement Plan, the insurance company cannot issue you a pre-existing condition waiting period. An example of creditable coverage would be group health insurance through you or your spouse’s employer.

Not all states and plans have a pre-existing condition waiting period. Thus, it is important to understand the rules of your plan before enrolling.

What If I Miss My Medicare Supplement Open Enrollment Period?

Missing your Medicare Supplement Open Enrollment Period can make it more difficult to enroll in a Medigap plan in the future. As we mentioned above, during your Medicare Supplement Open Enrollment, you can enroll in a policy without undergoing medical underwriting. If you miss this period, you can still enroll in a Medicare Supplement plan at a later time, however, the following may apply:

• You may have to answer questions about your health (also called medical underwriting)
• You may have to pay more for your policy
• You may be denied coverage if you don’t meet medical underwriting requirements

There are situations where you can purchase a Medicare Supplement plan without medical underwriting outside of your Medicare Supplement Open Enrollment Period. These situations often occur when your health coverage changes, giving you “guaranteed issue rights”. Guaranteed issue rights have specific rules regarding how to qualify, what rights you have, and how long you have those rights.

Aside from situations which give guaranteed issue rights, you may also enroll in a Medigap plan without underwriting outside of your MSOEP if your state has a state-specific Medicare Supplement birthday rule. Not all states offer birthday rules, and rules differ from state to state. You can check with your state’s State Insurance Department to see if a birthday rule is available and what the requirements are.

In addition to birthday rules, some states have year-round open enrollment for beneficiaries to enroll in a Medigap plan.

Who Receives a Second Medicare Supplement Open Enrollment Period?

Though not common, some individuals will receive two Medicare Supplement Open Enrollment Periods. This can occur if you get Medicare coverage prior to age 65 due to a disability, ESRD, or ALS. In this case, your first Medicare Supplement Open Enrollment Period will occur with your Medicare Part B effective date.

Your second Medicare Supplement Open Enrollment Period will begin when you turn 65. The reason individuals who qualify for Medicare under 65 get two MSOEPs is because they have limited Medigap options when they first become eligible. Some states do not require insurance companies to offer Medigap policies to people under 65. Even if a Medigap plan is available, beneficiaries under age 65 may face significantly higher premiums in certain states.

During both open enrollment periods, you can sign up for a Medicare Supplement plan without medical underwriting. There are also other instances where you may receive a second MSOEP. For example, if you retired and enrolled in Medicare Part B, but then re-entered the workforce and had employer coverage, you will receive a second MSOEP when you retire and enroll in Medicare Part B again.

Learn More About Enrolling in Medigap Coverage

The Medicare Supplement Open Enrollment Period is the best time to enroll in a Medicare Supplement Plan. However, should you miss this period, you may have other opportunities to enroll without undergoing medical underwriting. Review our resources below to learn more about what circumstances qualify for guaranteed issue rights. You can also learn more about the various types of Medicare Supplement plans available and how medical underwriting works.

For most, the Medicare Supplement Open Enrollment Period is a once-in-a-lifetime chance to get any Medigap policy available in your state. If you have questions about this enrollment period and would like to speak with a licensed insurance agent, you can contact our team using the phone number above. Our licensed agents can help answer your questions regarding Medicare Supplement Plans and enrollment periods.

Sources

Get Ready to Buy – Your Medigap Open Enrollment Period, Medicare.gov. Accessed January 2024

https://www.medicare.gov/health-drug-plans/medigap/ready-to-buy

Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare, Centers for Medicare & Medicaid Services. Accessed January 2024

https://www.medicare.gov/publications/02110-medigap-guide-health-insurance.pdf