Even after you sign up for Medicare, you still have to pay deductibles and copayments for hospital stays, doctor visits and other health care expenses.
But there’s a catch: If you don’t get the policy within a certain time frame, insurers in most states can reject you or charge more because of preexisting conditions. This limitation no longer exists for other kinds of health insurance.
To avoid this, find out when you can sign up and whether you might encounter any difficulties based on your health. Take the following steps to get the coverage you need:
1. Sign up at the right time
- For six months starting the month you sign up for Medicare Part B when you’re 65 or older. You’ll get the best price for any policy in your area based on your age, sex and smoking status.
- Up to 63 days after you’ve lost job-based health insurance that’s considered secondary to Medicare. If you’re 65 or older and you or your spouse works for a company with fewer than 20 employees, the employer’s insurance is generally considered secondary to Medicare. You may sign up for Part B while you still have the employer’s coverage since Medicare is the primary coverage but delay signing up for Medigap until the employer’s coverage ends.
- During a trial enrollment period. If you sign up for a Medicare Advantage plan when you first enroll in Medicare, you have up to 12 months to drop the plan, switch to original Medicare, and get any Medigap policy in your area. However, you forgo that trial right if you want to switch to a Medigap policy more than 12 months after enrolling in Medicare.
- If you dropped a Medigap policy to enroll in Medicare Advantage and want to switch back to original Medicare. You have up to 12 months to get the same Medigap policy.
- If you move out of your Medicare Advantage plan’s service area or your plan leaves the business.
Keep in mind that insurers can’t charge more or reject you because of your health. To learn more, read the Centers for Medicare & Medicaid Services’ Guide to Choosing a Medigap Policy.
2. Know your state’s rules
Three states — Connecticut, Massachusetts and New York — allow you to buy a Medigap policy anytime regardless of your health. The private companies that issue the policies also must charge everyone the same rate regardless of age, called community rating.
In these states, you can start out with a Medicare Advantage plan and pay lower premiums. Later, if you develop a health condition and want to use doctors and hospitals that aren’t in the plan’s network, you can switch to original Medicare and get a Medigap policy without having to pay more because of any preexisting conditions.
Maine requires insurers to offer Medigap Plan A, which offers the least amount of coverage, to anyone age 65 or older regardless of their health, for one month every year. The insurer decides which month.
Maine also extends the Medicare Advantage trial period from 12 months to 36 months. That means you have up to three years to switch back to original Medicare and get any Medigap policy.
Several states allow people who already have Medigap policies to switch plans without requiring them to answer questions about their health. Insurers in most states can offer up to 10 different plans, each labeled with a letter.
Plans with the same letter include the same benefits, but premiums can vary. You may be able to save money by switching to a different letter plan or a less expensive plan from a different insurer.