Medicare Supplement Plans

What is a Medicare Supplement (or Medigap) Plan?

Medicare supplement plans are one health insurance option for people with Original Medicare. There are standardized Medicare supplement insurance plans available that are designed to fill the gaps left by Original Medicare (Parts A and B). These are sold by private insurance companies as individual insurance policies and are regulated by the Department of Insurance. After age 65 and for the first six months of eligibility for Medicare Part B, beneficiaries have an Open Enrollment Period and are guaranteed the ability to buy any of these plans from any company that sells them. Companies cannot deny coverage or charge more for current or past health problems. If you fail to apply for a Medicare supplement within your Open Enrollment Period, you may lose the right to purchase a Medicare supplement policy without regard to your health.

Are you considering a Medicare Supplement Plan?

Use our free tool to find estimated premium rates

SHIIP's interactive tool allows you to compare Medicare supplement by entering your age, gender the Medicare supplement plan you want to compare and whether or note you use tobacco products to receive a list of companies offering that plan along with their estimated premiums.

You will not be auto enrolled into a Medicare supplement policy and must make application directly with the insurance company.  You will need to contact the insurance company that sells the specific policy that you wish to purchase, or you may contact an agent who sells the specific policy you want.  We recommend that you apply at least 30 days before you want the policy to start.  If you do not have thirty days, apply as soon as possible.  Supplement premiums are paid directly to the insurance company and are not deducted from your Social Security payments.

What's New for Medicare beneficiaries under age 65?

Medicare Supplemental Insurance federal regulations do not guarantee eligibility to individuals under age 65 who are eligible for Medicare due to disability.  However, thirty-three states have adopted state legislation extending guarantee issue to that group of individuals.  North Carolina is one of the states that legislatively mandates eligibility to individuals eligible for Medicare due to disability. 

North Carolina G.S. 58-54-45 guarantees that individuals under the age of 65 who qualify for Medicare are eligible to purchase a Medigap policy A, D, and G effective January 1, 2020.  This change took place due to changes in federal legislation regarding Medigap Plans A, C, and F.

Below is the link to review the new regulation.

North Carolina G.S. 58-54-45

What is the Open Enrollment Period?

The open enrollment period is six months from the date a beneficiary is enrolled in Medicare Part B. During the open enrollment period, a person under 65 and on Medicare disability is only able to purchase Medicare supplement insurance Plans A, D or G. This is a special North Carolina law.

During the open enrollment period, the applicant is guaranteed to be issued a policy. Premiums may be higher for Medicare disability beneficiaries than for Medicare beneficiaries 65 or older. The insurance company may impose a pre-existing condition waiting period, but it cannot be longer than six months. This would include any health condition diagnosed or treated six months prior to the Medicare supplement application. If a person has prior creditable coverage, the waiting period must be waived. Creditable coverage is when the beneficiary has been covered by insurance or Medicaid for six months prior to the effective date of the Medicare supplement insurance policy. When a Medicare disabled beneficiary turns 65 years old, he or she will have a new six-month open enrollment period and be able to purchase any of the standardized Medicare supplement insurance.

For those persons that are retroactively enrolled in Medicare Part B due to a retroactive eligibility decision made by the Social Security Administration, the application must be submitted within a six-month period beginning with the month in which the person receives notification of the retroactive eligibility decision.

Need more information?

Related Publications:

Medigap Under Age 65

Choosing a Medigap policy: A Guide to Health Insurance for People with Medicare

Medicare Supplement Insurance: Getting Started

Medicare Supplement Plans - Comparison Chart

Medigap Plans Company Names in North Carolina