Eligibility for Medicare Supplement Plans

Am I Eligible for a Medicare Supplement Plan?

Are you looking for a Medicare Supplement plan? Or maybe you are wondering if you are eligible for one? 

Private health insurance providers sell Medicare Supplement plans. However, unlike other health insurance plans, you may have to meet specific criteria to be eligible for a Medicare Supplement insurance plan. 

Eligibility with Original Medicare

Medicare Supplement plans work with your Original Medicare coverage, i.e., Medicare Part A and B. To qualify for a Medicare Supplement plan, you must first enroll in Medicare Part A and B. 

You must be either a U.S. citizen or a legal permanent resident for the last five consecutive years with the following qualifications: 

  • You must be 65 or older.
  • You are suffering from End-Stage Renal Disease (ESRD) – permanent kidney failure that requires either a transplant or regular dialysis. 
  • You are receiving disability benefits from the Railroad Retirement Board or Social Security Administration. Generally, you are eligible for a Medicare Supplement plan after continuously receiving disability benefits for the last 24 months. 
  • You have Lou Gehrig’s disease (ALS). 

Age Eligibility

In most states, age is a common eligibility criterion for the Medicare Supplement plan. Federal law does not require insurance providers to sell a Medicare Supplement insurance plan to someone under 65. 

Many states require health insurance providers to offer at least one type of Medicare Supplement plan to people under 65 with Medicare plans. 

Medigap Open Enrollment Period

If you are 65, you can purchase a Medicare Supplement plan during the Medicare Supplement insurance open enrollment period. This lasts for six months and starts on the first day of the month you turn 65 or enroll in Medicare Part B. 

During this time, you can purchase any Medicare Supplement plan from an insurance company without the risk of refusal or paying a higher premium due to a pre-existing health condition. However, the waiting period may apply in some cases. 

Once you enroll in the Medicare Supplement plan, pay your monthly premiums regularly to maintain coverage (along with your Medicare Part B premium). 

Remember, your Medicare Supplement plan does not cover any cost pertaining to Medicare premiums. 

Reasons for Refusal

Here are some reasons why you may face refusal charged higher premiums when applying for a Medicare Supplement plan: 

  • You have a Medicare plan, but you are under 65. 
  • You are 65 without Medicare Part B enrollment.
  • You have a pre-existing health condition, and your Medicare Supplement Insurance Plan’s open enrollment period has ended.

Seek Expert’s Advice

If you are unsure about your eligibility, it is best to seek an expert’s opinion before applying. The Medicare experts at Temmen Insurance can help! We will answer all questions you have regarding Medicare Supplement plans.

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