Garrett Ball

When Does Medicare Open Enrollment Start?

August 16, 2023 By Garrett Ball Leave a Comment

Every year around this time we start to get a few questions trickling in about when the Medicare Open Enrollment Period starts. By asking this question, Medicare beneficiaries are referring to the annual period where they get bombarded with television commercials, mailers, and (illegally) phone calls.

First and foremost, we should clarify that the technical name for this period is the “Annual Election Period” (AEP). It runs from October 15, 2023 to December 7, 2023. Even Medicare itself sometimes mistakenly and confusingly calls it the “open enrollment period”. Open enrollment for Medicare is actually when you turn 65. And open enrollment for Medicare Supplement plans is when you start on Medicare Part B for the first time (either due to turning 65 or starting on it later than that). But since most people call it open enrollment and so as not to get to hung up on jargon, we’ll use both terms interchangeably – annual election period and Medicare open enrollment.

What Changes Can You Make During Medicare Open Enrollment?

So, what changes can you make during the annual election period? This period is all about changing your Medicare Advantage plan or your Medicare Part D prescription drug plan. With either of those two types of plans, you have the opportunity to switch to another plan within your same insurance company or a different insurance company. Any changes that you make to your coverage will take effect on January 1 of the following calendar year.

If you are already on a Medicare Advantage plan or a Medicare Part D plan, you should receive something from your plan, by mail, in late September/early October detailing the plan’s changes for next year. This is called the annual notice of changes (ANOC), and it is a requirement that plans send this out and do so in a timely manner.

The plan coverage for the next calendar year will be available on Medicare.gov on or around October 1. So you would be able to log in and compare your current plan to what else is available after that date. But you cannot make any changes or enroll in a new plan until October 15.

Comparing all aspects of your plan is crucial to do if you are on Medicare Part D or Medicare Advantage. Both types of plans can change each year in terms of premiums, coverage levels, deductibles, and networks.

Can You Change Medicare Supplements During Medicare Open Enrollment?

The types of plans that are not in any way connected with the Annual Election Period are Medicare Supplement plans, also called Medigap. Medigap plans are plans from private companies that fill in the gaps in Medicare Parts A and B.

Open enrollment for Medigap is a 6-month period that begins on the first day you are in Medicare Part B, whether that is the month of your 65th birthday or later than that if you delay Part B enrollment. During that time period, you do not have to answer medical questions or qualify to get a Medigap plan. You can choose any plan from any company on an open enrollment basis.

After that initial 6 month window, regardless of the time of year that it is, you DO have to answer medical questions to get a Medigap plan (with a few exceptions of some states that prohibit underwriting in certain situations or at all).

So, yes, you can change your Medicare Supplement during the annual election period. However, you cannot do so an “open enrollment” basis – you will have to answer medical questions and get approved by the new insurance company in order to change your plan.

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65Medicare.org is a leading, independent Medicare insurance agency for people turning 65 and going on Medicare. If you have any questions about this information or would like to see if there is a mutual fit to work together, you can contact us online or call us at 877.506.3378.

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What is the Medigap “Birthday Rule” and Which States Have It?

August 13, 2023 By Garrett Ball Leave a Comment

Medigap plans are private insurance plans that provide standardized coverage to fill in the “gaps” in original Medicare Parts A and B. When you first turn 65 or start on Medicare Part B, you have an initial “open enrollment” period during which you can select any plan from any insurer offering those plans in your state (When is Open Enrollment for Medigap?). After that initial period, you typically have to “qualify medically” in order to change plans or companies. However, in recent years, more and more states are adding some version of a “birthday rule” – this rule typically gives Medicare beneficiaries the ability to change plans or companies without having to go through medical underwriting.

The advantage of utilizing such a “birthday rule” open enrollment is that you can change to a lower premium plan that would provide you with the same medical coverage. Often, once you have been on a Medigap plan for a few years, the price has gone up a few times and there are potentially less expensive/same coverage options.

So, what states offer a “birthday rule” open enrollment period and how does those periods work? We’ve listed out the states that offer this provision, as of the date of this article, with some details about how it works in each state (varies by state).

California Birthday Rule

California was one of the original states to enact a “birthday rule” for Medigap open enrollment. In CA, the birthday open enrollment period lasts for 90 days, beginning 30 days before your birthday and ending 60 days after your birthday. During this time period, you can elect a new Medigap policy with equal or lesser benefits. The coverage will not be made effective until after your birthday (usually the 1st day of the following month) or beyond 60 days from the application date.

Idaho Birthday Rule

Idaho is one of the newer states offering the birthday rule to change Medigap policies. In ID, there is an annual 63 day open enrollment window during which you can replace your Medigap policy with a policy of equal or lesser benefits. Like CA, coverage will not be made effective until after your birthday or beyond 60 days from the application date.

Illinois Birthday Rule

Illinois is also a newer state offering the birthday rule. In IL, the birthday open enrollment period lasts for 45 days beginning on your birthday. During this time, you may replace your Medigap plan with a plan of equal or lesser benefits. There are two unique aspects of the IL birthday rule. First, you must be between the ages of 65 and 75 in order to make a change in IL using this birthday rule. Second, you must be changing to a plan offered through your current insurance company (i.e. an equal or lesser plan offered through a different subsidiary company of your current insurance company).

Kentucky Birthday Rule

The Kentucky birthday rule is an annual open enrollment period that lasts for 60 days. It begins on an individual’s birthday. During this time period, you can change your plan to a “like” plan with a different insurance company. For example, if you have Plan G with company X, you can switch to Plan G with company Y. The coverage would begin on or after the individual’s birthday (but no more than 60 days from their birthday).

Louisiana Birthday Rule

Louisiana’s birthday rule for Medigap, which just took effect in 2022, is an annual open enrollment period lasting 63 days and beginning on your birthday. To use this period, you must select a plan of equal or lesser benefits. Like the birthday period in IL, you must also select a plan through the same insurance company as your current Medigap plan. Coverage cannot be made effective prior to your birthday or beyond 60 days from the application date.

Maryland Birthday Rule

Maryland is one of the most recent states to pass birthday rule legislation for Medigap. The Maryland birthday rule for Medicare Supplement enrollees took effect on July 1, 2023. You must be in an active Medigap plan (not any other type of Medicare plan) at the time of eligibility to use this new rule. The Maryland rule specifies that you can switch to a Medigap plan with any carrier offering equal or lesser coverage. The time period for this eligibility period begins with your birthday each year and lasts up to 30 days after your birthday. During this birthday rule period, changes you make to your Medigap coverage are not subject to underwriting or health questions.

Missouri Birthday Rule

The Missouri birthday rule allows you to terminate your existing Medigap policy and select the same plan from a different company within 30 days of your policy anniversary date each year. Using this rule, you have up to 63 days from the termination date of your current plan to select a “like” plan from a new company and avoid going through medical underwriting.

Nevada Birthday Rule

Nevada’s annual open enrollment period lasts for 60 days and begins on the 1st day of your birthday month. During this time, you can replace your Medigap policy with any policy offering equal or lesser benefits without undergoing medical underwriting. Coverage cannot be made effective prior to your birthday or beyond 60 days from your application date. Get quotes on NV Medigap plans here.

Oklahoma Birthday Rule

The Oklahoma birthday rule lasts for 60 days and begins on your birthday. You are required to be currently enrolled in a Medicare Supplement with no gap in coverage greater than 90 days since your initial enrollment. You can replace your policy with a new policy with equal or lesser benefits. To use this birthday rule, you must both prove your current enrollment and have a statement from your insurer stating that you have not had a gap in coverage of more than 90 days since the effective date of coverage. Applications using the Oklahoma birthday rule can be submitted up to 30 days before your birthday, but coverage will not be made effective until your birthday or beyond 60 days from the application date.

Oregon Birthday Rule

Oregon’s annual open enrollment lasts 60 days, beginning 30 days before your birthday and ending 30 days after your birthday. During this time, you can replace your policy with a policy of equal or lesser benefits. Coverage cannot be made effective prior to your birthday or beyond 60 days after your application date.

Washington Open Enrollment Period

Washington’s open enrollment period is unique in that it is not tied to your birthday. Using WA’s open enrollment period, you can switch any time of the year to a “like” plan without underwriting or providing medical information. Also, with most plans, including B, C, D, E, F, G, M, or N, you can switch to any of those plans with a different company, regardless of whether it is higher or lower in benefits.

States with Year-Round Open Enrollment for Medigap

In addition to the states that have specific, annual open enrollment periods, there are a few states that have year-round open enrollment periods for people on Medigap plans.

As of the time of this article, there are three states that offer this: Connecticut, New York, and Vermont.

Other Considerations and Factors

Remember that you can change Medigap plans in any state at any time. The end-of-the-year annual election period (AEP), which many people refer to as Medicare open enrollment does not pertain to Medigap policies. However, if you are in one of the states listed above and you wish to change your plan outside of the state-specific periods, you will likely have to go through medical underwriting and be “approved” to change plans.

These state guidelines can change over time. It is always advisable to check with your specific state or a licensed independent broker who can advise you on your options and provide you with a list of the Medigap options available to you.

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Medicare Supplement Insurance Companies: Top 10 to Consider

July 12, 2023 By Garrett Ball Leave a Comment

Many people ask us the question “What are the Top 10 Medicare Supplement Insurance Companies?”. This is certainly a good question to be asking for someone who is turning 65 or starting on Medicare for the first time. The answer may surprise you in its simplicity. In short, the best Medicare Supplement insurance company is the one that has competitive pricing for your area and a solid rating.

With Medicare Supplement plans, the plans are completely Federally-standardized. All companies are required to offer the same coverage options from the standard Medigap coverage chart. This means that each company will provide the same coverage. Therefore, it is easy to make an “apples to apples” comparison on the coverage that Medicare Supplements offer. A Plan G, for example, with one insurance company is the exact same as a Plan G with a different insurance company.

In addition, all Medicare Supplements can be used at any doctor/hospital that takes Medicare, so there are no network considerations like there are on other types of medical insurance. Lastly, the claims for Medicare Supplements are all processed through the same Medicare “crossover” system, so there is no variation in how well or how fast a Medicare Supplement company pays claims.

Despite these standardizations, there are some Medicare Supplement companies that are larger or more notable than others in terms of plan availability and historical stability. We’ve listed those below in our list of top 10 Medicare Supplement insurance companies.

Mutual of Omaha Medicare Supplements

Mutual of Omaha offers plans through several subsidiary companies, and those subsidiaries vary in different states. They have been in business for over 100 years, and they have an ‘A+’ rating by AM Best. They also offer an industry-leading 12% household discount and do not require the other household resident to be a policyholder in order to get that discount (there are some state-specific exceptions to this). In most states, they are competitively priced and are a solid option to consider for Medicare Supplement coverage. You can enroll in a Mutual of Omaha Medicare Supplement plan online.

AARP Medicare Supplement plans, insured by United Healthcare

The AARP Medicare Supplement plans, insured by United Healthcare, are also a great option to consider for Medicare Supplement coverage. They offer a wide variety of the standardized plans and offer plans in all 50 states. You do have to be an AARP member in order to be eligible to sign up for one of their plans. They also offer discounts for paying by monthly bank draft as well as a household discount (discount percentage varies by state) for those eligible.

Aetna Medicare Supplements

Aetna is another of the Medicare Supplement insurance companies that you may want to consider. As one of the largest providers of Medicare Supplement plans nationally, they also offer plans through the parent company or a subsidiary company in most states. Typically, you will find them to be one of the more competitively-priced options in most locations. They have an easy-to-use policyholder website and a household discount in most states.

CIGNA Medicare Supplements

CIGNA Medicare Supplements are one of the more popular options nationally as well. CIGNA offers plans through one of their subsidiary companies in most states. They also have the largest available household discount for two members of the same household signing up for their plans (20% in most states).

Humana Medicare Supplements

Humana is one of the largest providers of multiple types of Medicare insurance. Humana’s Medicare Supplement plans come in as very competitively priced in some states, but as with all of these companies, it is important to note that rates vary considerably depending on where you live. Humana offers many of the standardized Medicare Supplement plans in most locations, and they often have some of the most competitive rates on the high deductible Plan G.

ACE Medicare Supplements

ACE is a newer company to Medicare Supplement plans; however, ACE Medigap plans have a great rating and have been offering other types of insurance such as property and casualty for a long time. In many states, their rates, as of the publication date of this article, are among the lowest available on common plans such as Plan G and Plan N. Because they are newer to offering Medicare Supplement plans, some may want to give them some time to see how their rates hold up over time, but they are definitely an option to keep an eye on and consider for Medicare Supplement coverage.

United American Medicare Supplements

United American makes the list of best Medicare Supplement insurance companies as well. Their rates are not as competitive in every state, but they do excel in certain geographic areas and for certain plans (specifically, they often have great rates on the high deductible Plan G). United American has been in business for many years and has solid ratings for financial strength.

New Era / Philadelphia American Medicare Supplements

New Era and Philadelphia American are “sister” companies that offer Medicare Supplements. Although they are lesser known than some of these other companies, they have historically had competitive pricing and reasonable rate histories. In some locations, they have had some of the lowest rates for several years. When comparing Medicare Supplement insurance companies, you will find that they often come up as one of the lower priced options.

Medico Medicare Supplements

Medico and their subsidiary companies have been offering Medicare Supplement insurance plans for many years. They have a large household discount (10% in many states) and often come in near the lowest rates for Medicare Supplements. In many areas, they also offer a dental/vision that can be paired with their Medicare Supplement plans.

Manhattan Life Medicare Supplements

Manhattan Life is one of the smaller of these companies as well, but they have been offering Medicare Supplement plans for many years and typically have very competitive pricing. They give a solid 7% household discount in many states and have an AM Best rating that has increased in recent years.

The Bottom Line: Top Medicare Supplement Insurance Companies

The bottom line on choosing from the available Medicare Supplement insurance companies is that it is very specific to your situation – where you live, your age, and whether you qualify for any of the various household discounts that the companies offer. Because of this and because of the plan standardization, it is not feasible or accurate to say one company is the “best Medicare Supplement company”.

However, there are companies that are larger than others, have longer track records, and higher ratings than their counterparts. When you are shopping for a Medicare Supplement, it is prudent to view all of the available plans to you and make a selection based on the premiums they offer and their history and ratings. You can get a list of the plans for your area, delivered by email, if you want more information customized to your situation and location: request Medicare Supplement list.

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65Medicare.org is a leading, independent Medicare insurance agency for people turning 65 and going on Medicare. We have worked with 10,000+ Medicare-eligible individuals over the last 10+ years, assisting with understanding and comparing the plans. You can get a list of Medigap quotes in your area. Or, if you have any questions about this information, you can contact us online or call us at 877.506.3378.

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How to Sign Up for Medicare When You Are Turning 65

April 27, 2023 By Garrett Ball Leave a Comment

Signing up for Medicare is one of the important steps you need to take when you are turning 65. In recent years, the process has been streamlined and become something that can be handled all online without having to make the trek to a local Social Security office. This article is intended to be a detailed guide on who needs to sign up for Medicare, how to sign up for Medicare, and when you should sign up.

Who Needs to Sign Up for Medicare

First and foremost, you need to know whether you even need to sign up for Medicare. If you are already receiving Social Security benefits prior to turning 65, you should be enrolled into Medicare A & B automatically as of the 1st day of the month that you turn 65. If this is the case, you will receive your Medicare card in the mail about 3 months prior to your Medicare start date.

If you are planning to continue working or are covered under an employer/group plan that you plan to keep even after you are Medicare-eligible at age 65, you do need to sign up for Medicare. In this case, you are permitted to delay enrollment into Medicare and sign up at a later time, without penalty, when you drop or lose that employer/group coverage.

If neither of the above-mentioned circumstances apply to you, however, you will need to proactively sign up for Medicare.

How to Sign Up for Medicare

Signing up for Medicare can be done all online now. You can complete that process at this link on Social Security’s website: Sign up for Medicare | SSA. You will need some basic information about yourself in order to successfully sign up, including your Social Security number, where you were born (city, state, country), your date of birth and information about your current health insurance.

Alternatively, if you do not wish to sign up for Medicare online, you can also sign up by going to a local Social Security office.

When To Sign Up for Medicare

So, when should you sign up for Medicare? If you are planning to go on Medicare as your primary coverage when you turn 65, it is advisable to sign up for Medicare 2 or 3 months before your Medicare start date. Your Medicare start date would be the 1st day of the month that you turn 65, unless your birthday is on the 1st of a month, in which case your Medicare start date would be the first day of the preceding month.

If you are already over 65 and just need to add Medicare Part B, you can also do that online. And, you should do it at least a few weeks before you want your Part B to begin, when possible. Signing up for Medicare in advance ensures that you will have time to get your Medicare card in the mail prior to the start date of your Medicare coverage.

Signing Up for Other Medicare Plans

Around the same time that you sign up for Medicare itself, you should also consider any other Medicare-related plans that you need. Medicare Part D is the part of Medicare that covers prescription drugs so if you plan to stay with “original” Medicare (Medicare A & B vs Medicare Advantage), you will also need to add a Part D plan to have drug coverage.

Likewise, if you want to have coverage to fill in the gaps in Medicare A & B, the best time to sign up for that is during your initial open enrollment period when you turn 65. You can compare Medigap policies at this time to choose a Medigap plan that fits your specific needs and is available in your area.

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Should I Change My Medigap Plan If the Rate Goes Up?

April 24, 2023 By Garrett Ball Leave a Comment

Should you change your Medigap plan if your rate increases? This is a great question and one that many Medicare beneficiaries ask as they get older and experience changes to their Medigap premiums. The short answer is “Yes!”; however, the answer is a little more complex than that.

First, let’s start with a basic fact – just like most other things in our lives and other types of insurance, your Medigap rate is going to go up over time! No matter what your insurance agent told you when you signed up, it is going to go up over time. Now, different companies may go up different amounts and future increases are very difficult to predict because they are based on claims ratios, changes to Medicare, and inflation – three variables that are uncertain. One thing that is not uncertain, though, is that the rate is going to go up. (Related: How Much Do Medigap Premiums Go Up Each Year?)

With that basic fact out of the way, WHEN it does go up, you should receive a notification by mail from your insurance company about 30-60 days in advance of when the rate is going to change. For most companies, rate changes occur in your policy anniversary month. This is usually your birthday month, assuming that you signed up for a Medigap plan the month you turned 65. The letter you receive will contain your new rate and should act as a prompt for investigating whether it makes sense to stay with the same plan or explore other options.

In most cases, especially if you have had the same Medigap plan for more than a year or two, there will be other options available for equivalent coverage (all plans are standardized – Medigap coverage chart) at a lower premium. If you have a broker, the broker should be able to easily provide you with a full list of plans so you can see how your rate compares to what else is available for your zip code and age. If you can save money for the same plan, it may make sense to change to a different company.

When Can You Change Your Medigap Plan?

Contrary to common misconception, you can change your Medigap plan at any time of the year. You don’t have to, and really shouldn’t, wait until the end of the year to change plans. The end of the year annual election period (what people call “open enrollment”) is all about Part D and Advantage plans and does not have anything to do with Medigap. Moreover, there are more people changing plans at that time of year and underwriting is different and slower.

The best time to change your Medigap plan is one month before your rate increase is going to take effect, making the new plan effective on the date that your current plan is changing its rate. In other words, in a hypothetical situation, you get a notice that your plan is going up in late April and the change is going to take effect on your policy anniversary date of 6/1 because that is your birthday month and you signed up when you turned 65. Once you get that notice, you review other plan premiums and see that you can save $40/month by switching from your current Medigap company to a different Medigap company for the same Plan G coverage. You can do an application in April or early May for a 6/1 effective date (usually takes 7-10 business days to be approved) and avoid the increase and save some money while keeping the same coverage.

How Do You Change Your Medigap Plan?

Changing Medigap plans is relatively easy to do, particularly if you are in pretty good health. When you first turn 65 or start on Medicare, you have an open enrollment during which you do not have to answer medical questions or be approved into a Medigap plan. However, after that initial 6 month open enrollment period, you do have to “qualify medically” in most instances (exceptions: states that have a birthday rule).

So, part of the changing process will be completing an application, providing health/medication information and going through review by an underwriter.

But the first step to changing your Medigap plan is reviewing Medigap quotes. This can be done by contacting your Medigap broker if you have one. He or she can provide you with a list of available Medigap plans and their premiums and even make recommendations based on their previous experiences with the different companies.

Once you have selected a new plan to apply for, you would complete an application for the new company. This can typically be done online or by phone in a matter of minutes. It usually takes about 7-10 days for the new company to review your application and approve it.

Medigap Underwriting Process

As mentioned above, a new Medigap policy will need to go through underwriting unless you fall into a unique situation or live in one of the states that has a “birthday rule”.

This underwriting process varies from company to company, as all companies ask different health questions and have different requirements. Aside from filling in health and medications information on the application itself, you also may need to have a telephone interview with a Medigap underwriter as part of the approval process.

Reviewing each company’s underwriting guidelines and processes is something your Medigap broker should be able to assist with as part of the company selection process.

If you have any questions about this process or would like a list of the plan options available to you, please contact us here or call us at 877.506.3378.

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