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Am I Eligible for a Medicare Supplement Plan?

Unlike Original Medicare, Medicare Supplement plans are sold by private insurance companies. However, you may be eligible for a Medicare Supplement plan only when you turn 65 or older. Federal law doesn’t require these private insurance companies that sell Medicare Supplement Plans to sell them to people under age 65.

Why would I want a Medicare Supplement plan?

Medicare Supplement plans also called “Medigap” help fill the gaps in your Original Medicare coverage. Medicare Supplement plans may cover coinsurance, copayments, and deductibles. For example, some Medicare Supplement plans may cover:

  • Your Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up
  • Your Medicare Part B coinsurance or copayment
  • Skilled nursing facility care coinsurance
  • Medicare Part A deductible
  • Medicare Part B deductible

Medicare Supplement plans only work together with Original Medicare and cannot cover out of pocket costs of Medicare Advantage plans.

What do I need for Medicare Supplement Plan Eligibility?

There generally three requirements for Medicare Supplement plan eligibility, although there may be exceptions.

  • You must be enrolled in Medicare Part B (You may also be automatically enrolled in Medicare Part A).
  • You must be 65 or older
  • You must be in your 6-month Medicare Supplement Open Enrollment Period

What is the Medicare Supplement Open Enrollment Period?

Generally, the best time to get the Medicare Supplement policy you want is during your 6-month Medicare Supplement open enrollment period. This period starts the month you’re both 65 and enrolled in Medicare Part B (medical insurance). Keep in mind that your Medicare Supplement Open Enrollment Period is tied to your birthday and your Medicare Part B enrollment and may be different from your spouse or friends.

During you Medicare Supplement open enrollment period you have “guaranteed issue rights.” This means that you are immune from medical underwriting. Medical underwriting is where insurers consider your health conditions when deciding whether or not to provide you coverage and how much to charge you. If you have a serious illness and appear expensive to cover, they may either deny you coverage or charge you more for coverage.

Do I still have Medicare Supplement plan eligibility outside of my open enrollment period?

Some states require insurance companies to offer at least one kind of Medicare Supplement policy to people with Medicare under 65. However, you may not get the plan you want until you are 65. These states are:

  • California, Colorado, Connecticut, Delaware, Florida
  • Georgia, Hawaii, Idaho, Illinois, Kansas, Kentucky
  • Louisiana, Maine, Maryland, Massachusetts, Michigan
  • Minnesota, Mississippi, Missouri, Montana, New Hampshire
  • New Jersey, New York, North Carolina, Oklahoma, Oregon
  • Pennsylvania, South Dakota, Tennessee, Vermont Wisconsin

In California and Vermont, a Medicare Supplement policy is not available to people under 65 with end-stage renal disease. If you are under 65, you also may pay more than someone who is 65 or older.

If you are 65 are older and apply for a Medicare Supplement plan outside of your open enrollment period, you will probably be subjected to underwriting requirements.

To find a Medicare Supplement plan in your area, enter your zip code on this page.

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