Who qualifies for Medicare supplemental insurance?

Medicare supplemental insurance, often called Medigap, offers a way for beneficiaries to reduce their out-of-pocket healthcare costs. These policies work alongside original Medicare (Parts A and B) to cover expenses like deductibles, copayments, and coinsurance. However, not everyone can easily enroll in a Medigap plan.

Eligibility for Medigap is primarily determined by specific enrollment periods and, in some states, age. The most guaranteed way to get a Medigap policy is during your Medigap open enrollment period. This six-month window begins when you are both 65 or older and enrolled in Medicare Part B. During this time, insurance companies cannot deny you coverage or charge you more due to health status.

Outside of this open enrollment period, or if you are under 65, obtaining a Medigap policy can be more challenging. Some states offer protections that allow individuals under 65 with disabilities or End-Stage Renal Disease (ESRD) to purchase Medigap plans. However, in most other situations, if you miss your open enrollment window, you may face medical underwriting. This means insurers can deny coverage or charge higher premiums based on your health conditions.