Changing Medicare Supplement Plans

By Joan Opiyo
eMedicareSupplements Contributor

If you are not satisfied with your Medicare supplement coverage, you may wonder whether you can switch to a new Medigap policy. You might want to switch if you are paying for unnecessary benefits and want to lower your monthly premium. You also might consider a switch if you require more benefits than you're currently receiving or have had trouble dealing with your insurance carrier. In most cases, however, switching to a new Medicare supplement policy will subject you to the possibility of being denied or penalized for medical reasons unless you happen to find yourself within a guaranteed-issue period, in which case you have the right to switch with impunity. The only exceptions to this would be if your state's laws allow you to switch Medigap plans or if your carrier consents to selling you a different policy.

If you are eligible to switch policies, you are not required to wait a certain period of time before switching. However, if your original policy is less than six months old, the insurer may not be required to cover a pre-existing condition for up to six months. If the original plan is more than six months old and both plans have the same benefits, your pre-existing condition must be covered by the new insurer.

You are never required to switch Medicare supplement plans, even if you have a policy that appears to be old or outdated. This includes supplemental policies acquired before 1992, when plans became standardized, or standardized plans that have been discontinued by Medicare, such as plans E, H, I and J. You do not have to switch Medicare supplement policies if you move to a new state unless you have a Medicare SELECT policy, which requires you to seek care within a preferred-provider network. If have a Medicare SELECT policy and move to a new state outside your provider network, you have guaranteed issue rights to switch to a new Medicare supplement plan either offered by your existing insurance company (if it serves that state) or a new company.

If you decide to switch from Medigap to a Medicare Advantage plan, your Medigap policy will not be able to pay the deductibles, co-insurance or co-payments required by your Medicare Advantage plan. Because the two types of plans are incompatible, you should choose either Medicare Advantage or a Medigap plan. If you do switch from a Medigap plan to Medicare Advantage, you are allowed to switch back to Medigap within your first year on Medicare Advantage under guaranteed issue trial rights. Medigap beneficiaries will need to purchase a stand-alone Medicare Part D plan for prescription drug coverage if the basic drug coverage provided by Medicare is not sufficient. Current Medigap plans do not offer prescription drug coverage. If you have an older Medicare supplement plan that includes prescription drug coverage and wish to purchase a new Part D plan, the new coverage will replace any drug benefits you received from your supplemental plan. You will need to inform your supplemental insurance carrier of your new Part D plan. They will remove the drug coverage from your policy and adjust your monthly premium accordingly.