Eligibility for Medigap Plans Pt 1

Are you considering getting a Medicare supplement plan, also referred to as Medigap? You may already know that this insurance can pay part of your original Medicare costs (Part A and B). However, you may wonder when you will become entitled to this insurance.

Medicare is a public health policy administered by the Department of Health and Human Services of the United States. In general, it offers hospitals, health insurance and prescriptions for Americans over 65 years old.

Citizens and permanent residents of the United States are entitled to Medicare if they have been employed for a minimum of 40 fiscal quarters in an employement position that contribute to the Medicare policy. People currently employed can look at their paychecks. Many companies show the amount paid in Medicare with their own line item. It can be combined with social security taxes. The Medicare right also applies to the spouse.

There are certain situations and times in which you are eligible for Medigap.

When do I qualify for Medigap plan?

Because the Medicare guidelines supplement your original Medicare coverage, you must sign in to Part A and Part B to qualify for this type of policy. You must also remain enrolled in Original Medicare for your medical and health insurance. Medicare supplemental plans are not for independent health insurance. These plans only help cover a cost that Original Medicare does not cover.

If you are under 65 and you enrolled for Medicare because of end-stage kidney disease, disability, or amyotrophic lateral sclerosis, your right to Medicare supplement may depend on the state in which you reside.

Also keep in mind that Medicare supplement plans do not have any prescription drug benefits. Some supplemental Medicare plans may have included this coverage in the past; however, plans sold today do not include prescription drug benefits.

If you have a previous Medicare supplement policy with prescription drug coverage, make sure this coverage is “acceptable”; otherwise you can pay a late registration fee later if you enroll in Part D later.

Because Medigap plans do not have prescription benefits, you can get this coverage if you are enrolled in Original Medicare and need help with prescription drug costs when you enroll in a separate Medicare prescription drug plan.

How can enrollment times influence my qualification for Medigap plans?

The open enrollment period for Medicare supplement is the best time to enroll in a Medicare supplement plan. For most people, this period begins the month they turn 65 and have Medicare Part B, and it lasts for 6 months. This is the time when you will receive a complementary Medicare plan that is available in your area, regardless of your health problems. The insurance company cannot charge you higher fees if you have health problems or refuse you coverage due to existing conditions. The special protection you get during this period is referred to as guaranteed issue rights.

Bear in mind that, although for health reasons, the Medicare Supplement cannot deny your enrollment, but you may be asked to wait for up to 6 months before you meet your current conditions.