Video: Medigap for People Under 65



Video Transcript

Jennifer: In the previous video we discussed how a person receiving Social Security Disability benefits can obtain Medicare benefits. Now we will discuss how Medicare supplemental insurance, or Medigap, works with Medicare.

Original Medicare pays for many healthcare services and supplies, but it doesn't pay all your healthcare costs. There are costs you must pay like deductibles, co-insurance and co-payments. These costs are sometimes called gaps in Medicare coverage.

A Medigap policy is a health insurance policy sold by private insurance companies to fill the gaps in original Medicare coverage. There is no Medigap open enrollment period under Federal law for people who are under age 65 and have Medicare because of a disability or End Stage Renal Disease, ESRD.

State law may provide more generous protections requiring enrollment for people under age 65. Some states require Medigap insurance companies to offer a Medigap open enrollment period for people with Medicare Part B who are under age 65.

Medigap policies sold to people under age 65 may cost more than policies sold to people over age 65. If you have Medicare before age 65, you may not be able to buy a Medigap policy without underwriting, or at all. However, if you have Part B when you reach age 65, you will have the right to choose and buy any Medigap policy during the open enrollment period even if you had Part B before age 65.

Okay, Mr. Benefit, what else can you tell us about the Medigap open enrollment period?

Mr. Benefit: Jennifer, you can buy a Medigap policy during the Medigap open enrollment period. The enrollment period is for six months after you are age 65 and are enrolled in Medicare Part B. During this time you can buy any Medigap policy offered in your state.

Insurance companies cannot refuse to sell you a Medigap policy or charge you a higher premium due to a pre-existing condition or other health problem. If you already have a Medigap policy in a state that provides open enrollment for people under age 65, you may be able to get a better rate if you re-apply at age 65.

If you are under age 65 and enrolled in a Medicare Advantage plan, at age 65 you can choose to return to original Medicare and use your Medigap open enrollment period. You can leave your Medicare Advantage plan even if you are not in a Medicare Advantage open enrollment period. Also, you can sign up for a Medicare prescription drug plan.

Some insurance companies may voluntarily sell Medigap policies to some people under age 65. And some states require that people under age 65 who are buying a Medigap policy be given the best price available.

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