In order to be eligible for Medicare Supplement Insurance (also called Medigap), you must be enrolled in Medicare Part A and Part B (Original Medicare).
Medigap plans are more widely available to people 65 and older, but some people may be able to get a Medigap plan under 65 if they are eligible for Medicare due to a disability or End-Stage Renal Disease (ESRD).
Some people may qualify for Medicare under age 65 due to a disability or End-Stage Renal Disease (ESRD). If you qualify to enroll in Medicare under 65, you may also be eligible for a Medigap plan.
Federal law does not require insurance companies to sell Medigap plans to individuals under the age of 65, even if they are eligible for Medicare because of a disability.
The following states do require insurance companies to make at least one Medigap plan available to qualified beneficiaries under the age of 65:
Keep in mind that insurance companies in other states (not on the above list) may also offer Medigap plans to people under 65. They are simply not required to do so under state law. If this is the case, you may not be able to buy a Medigap plan in your state if you are under 65.
If you are able to find a Medigap plan in your state, it may be considerably more expensive than it is for people 65 and older. Some states regulate how insurance companies price their Medigap plans for Medicare beneficiaries who are under 65.
Some of the states listed above might offer multiple Medigap policies to beneficiaries under 65. Some may even offer the same selection of plans that are available to those 65 and over.
Some states might only offer one type of Medigap plan to people under 65.
State laws regarding Medigap can vary considerably. Check with your state’s department of insurance to learn more about how Medigap is regulated where you live.
If you are eligible for Medicare because you are turning 65, the earliest time you can buy a Medigap plan is during your Medigap Open Enrollment Period (OEP), which begins as soon as you are at least 65 and enrolled in Medicare Part B.
During your Medigap Open Enrollment Period, insurance companies can’t use your medical history or current health status to determine your eligibility for a Medigap plan or to charge you higher plan premiums.
If you qualify for Medicare under 65, you may be given a Medigap Open Enrollment Period before you turn 65, depending on which state you live in. However, this is not a federal mandate and state laws vary considerably. Again, check with your state department of insurance to learn more.
Regardless if you do or don’t buy a Medigap plan under 65, you’ll still get a Medigap OEP when you turn 65. You’ll still be able to buy any Medigap plan in your state during that period without medical underwriting.
A licensed insurance agent from MedicareSupplement.com can help you compare Medigap plans in your area and determine if you are eligible for a plan.
Outside of your Medigap Open Enrollment Period, you may have what are called “guaranteed issue rights.”
Having a guaranteed issue right means insurance companies cannot perform any medical underwriting in determining your Medigap premium. In other words, you cannot be charged more for a plan because of your health. There are several circumstances that could qualify you for a Medigap guaranteed issue right.
Guaranteed issue rights do not always exist for Medicare beneficiaries under the age of 65. Price protections for people under 65 vary by state — contact your state’s department of insurance to learn more.
Federal law requires that once beneficiaries in any state turn 65, they be granted the same guaranteed issue rights that are given to Medicare beneficiaries who are 65 and over.
Another option Medicare beneficiaries under 65 can consider is a Medicare Special Needs Plan (SNP).
A Medicare SNP is a type of Medicare Advantage (Part C) plan that is designed for beneficiaries with a particular health condition or financial circumstance.
Some Medicare Special Needs Plans are available for people with End-Stage Renal Disease and certain other chronic health conditions. Each plan will typically feature a set of benefits that are tailored to help meet the unique needs of its members. SNP availability can vary by location. An SNP that would work well for your needs may not be available in your area.
A Medicare SNP is not the same thing as a Medigap plan. You cannot have a Medigap plan and a Medicare SNP at the same time.
A licensed insurance agent can help you navigate the rules in your state regarding Medicare Supplement Insurance enrollment, even if you are under 65.
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