Medigap Questions – I Have …. Can I Get a Medigap Plan?

Medigap plans are plans that are designed to fill in the gaps in Medicare A & B. These plans are sold through private insurance companies. When you first turn 65 or go on Medicare, you have a 6-month open enrollment period, during which you can sign up for a plan without any medical underwriting. In other words, you do not have to answer any health questions at all in order to get a plan. After that time period has passed, however, you do have to answer health questions at any time that you apply for a plan. Contrary to popular belief, Medigap plans do not have an annual enrollment period during which you change plans without underwriting. That only applies to Medicare Advantage and Part D plans.

So, dealing with Medigap plans, how do you know if you can change plans? First of all, it is important to understand that Medigap plans are standardized, so if you have a Plan G now, for example, another Plan G is going to provide the exact same coverage. You can easily compare that way to see if it makes sense to pursue another plan. You do, however, have to answer medical questions to make that change.

Different companies ask different medical questions. In general, companies are looking for the “big stuff” – i.e. heart attack, cancer, stroke, insulin-dependent diabetes, organ replacements, upcoming surgeries, etc. Most all companies ask about (and use as a disqualification) those things. Other things are also asked about on some companies applications. These range widely and any time you are considering a change, you should simply examine the health questions on a companies’ application to see if you would be able to pass underwriting. Most companies do also ask about any medication usage. It is important to note that this applies to most states – there are a few states that have special provisions prohibiting this underwriting at all or during certain times (i.e. your birthday month).

One more implication that must be discussed is that there are also time periods – called “guaranteed issue” – that you can get a plan without medical underwriting. Some of these time periods are losing employer coverage, dropping employer coverage, moving out of your plan’s service area, losing your Medicare Advantage plan, etc.

If you have any questions about Medigap or Medicare, in general, we are happy to help. Reach out to us via our website – – or call us at 877.506.3378.

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