Switching Medigap Policies

medicare plans

If you are unhappy with your Medigap coverage, you are losing your coverage, or you have a policy with Medicare prescription drug coverage, you may be thinking about switching to a new Medigap policy.

Can I Switch Different Medigap Medicare Plans?

In most cases, you won’t have a right under Federal law to switch Medigap policies, unless you are within your 6-month open enrollment period or are eligible under a specific circumstance for guaranteed issue rights. However, if your state has more generous requirements, or the insurance company is willing to sell you a Medigap policy, you may be able to switch policies.

If you bought your Medigap policy before 1992, it may offer coverage that isn’t available in a newer Medigap policy. On the other hand, older policies might not be guaranteed renewable and might have bigger premium increases than newer standardized Medigap policies currently being sold. If you decide to switch, don’t cancel your first policy until you have decided to keep the second policy.

Do I Have to Switch Policies if I Have an Older Medigap Policy?

No. If you have an older Medigap policy that you bought before 1992, you don’t have to switch to one of the standardized Medigap policies. If you do buy a newer Medigap policy, you won’t be able to switch back to your old policy because older Medigap policies can no longer be sold.

Do I Have to Wait a Certain Length of Time After I Buy My First Medigap Policy Before I Can Switch to a Different Policy?

No, you do not have to wait a certain length of time to switch policies. However, if you have had your old policy for less than 6 months, the Medigap insurance company may be able to make you wait up to 6 months for coverage of a pre-existing condition before you can switch. If your old policy had the same benefits, and you had it for 6 months or more, the new insurance company can’t exclude your pre-existing condition.

If the new Medigap policy has a benefit that isn’t in your current policy, you may still have to wait up to 6 months before that benefit will be covered; regardless of how long you have had your current Medigap policy.

Why Would I Want to Switch to a Different Medigap Policy?

There may be many reasons why you would want to switch to a different Medigap policy. Some reasons may include the following:

  • You may be paying for benefits you don’t need.
  • You may need more benefits now than you needed at the time you bought the policy.
  • You are unhappy with the insurance company.
  • You would like to switch to a policy that is less expensive.

Do I Have to Switch Medigap Policies if I Move to Another State?

You can keep your current Medigap policy regardless of where you live as long as you are still in Original Medicare. If you want to switch to a different policy, you will have to check with your insurance company to see if they will offer you a different Medigap policy. You may have to pay more to switch to your new Medigap policy and answer some medical questions if you are buying a policy outside of your Medigap open enrollment period.

If you have a Medicare SELECT policy and you move out of the policy’s area, you have the following choices:

  • Switch to a different policy from your current Medigap policy insurance company. It may offer the same or fewer benefits than your current Medicare SELECT policy.
  • Switch to a new Medigap policy from a different insurance company. You have a guaranteed issue right to buy a Medigap plan from any insurance company that sells them.

What Happens to My Medigap Policy if I Join a Medicare Advantage Plan?

Medigap policies don’t work with Medicare Advantage Plans. If you join a Medicare Advantage Plan, your Medigap policy can’t pay any deductibles, copayments, or coinsurance. If you want to switch to a Medicare Advantage Plan, you may want to drop your Medigap policy.

However, if you leave the Medicare Advantage Plan you might not be able to get the same policy back later, or in some cases, any Medigap policy. Your rights to buy a Medigap policy vary by state. You do have a legal right to keep the Medigap policy after you join a Medicare Advantage Plan, but you will have to continue to pay the Medigap premium.

What Happens to My Medigap Policy If I Switch to a Medicare Prescription Drug Plan?

Your Medigap prescription drug coverage may have met your needs if your premium or your prescription drug needs were very low. However, if your Medigap premium, or your costs for prescription drugs has increased recently, you may want to switch to a Medicare Prescription Drug (Part D) Plan, as it might now be a better choice.

With a Medigap policy, you will pay the whole premium for your prescription drug benefit. These policies also have a maximum amount that they pay each year for prescription drugs. Although you may have to pay a monthly premium for a Medicare Prescription Drug Plan, Medicare pays most of the drug costs. Before you switch to a Medicare Prescription Drug Plan, you should check to see if your current prescription drugs are on the plan’s list of covered drugs.

Can I Switch to a Medicare Prescription Drug Plan and Have a Medigap Policy with Prescription Drug Coverage?

No, these two do not work together. If your policy covers prescription drugs and you switch to a Medicare Prescription Drug Plan, you must tell your Medigap insurance company. Your Medigap company needs to remove the prescription drug coverage from your policy. As soon as you notify them, they must adjust your premium to reflect the removal of your prescription drug coverage.

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