Switching outside your open enrollment period
Your Medigap open enrollment period is the six months that start when you're 65 or older and enrolled in Part B. After it ends, Medicare.gov says that in most cases you won't be able to switch without the new company reviewing your health, unless a guaranteed-issue right applies. In Texas, the company can then:
- Ask health questions and turn you down,
- Charge a higher premium based on your health, or
- Make you wait up to six months before new benefits or a preexisting condition are covered.
Some states give people a yearly or birthday right to switch. Texas isn't one of them; TDI's Medicare supplement guide describes no such right.
When you can switch without health questions
A guaranteed-issue right lets you buy certain Medigap plans without health questions, generally within 63 days after other coverage ends. Common situations include your Medicare Advantage plan ending, the 12-month trial right after first trying Medicare Advantage, and your Medigap company going out of business or misleading you. See when can I buy Medigap in Texas.
How to switch safely
- Apply for the new policy first. Don't cancel your current one.
- Once the new policy is approved and in force, you have 30 days to decide.
- Cancel the old policy in writing, and keep a copy.
Be wary of anyone who pushes you to drop a policy. TDI says that knowingly making misleading statements to get you to drop a policy and buy another is illegal; it's called twisting. You can report it to TDI at 1-800-252-3439.
Tip: Plans with the same letter, such as Plan G, have the same standardized benefits from every company. When switching, you're mostly comparing price, the company's rate history and service.
Get help
A licensed insurance agent with Benefits Life can compare Medigap policies from the companies they work with and explain whether health questions apply to you, at no cost to you, at (512) 265-6565, TTY 711. See Medigap in Texas.
Related questions
When can I buy Medigap in Texas?
Open enrollment and guaranteed-issue rights.
Can I get Medigap under 65 in Texas?
Disability, ESRD and ALS rules.
Can I switch Medicare Advantage plans after open enrollment?
Windows for Medicare Advantage changes.
Sources
- Texas Department of Insurance — Medicare supplement insurance guide
- Medicare.gov — Can I switch or drop my Medigap policy?
- Medicare.gov — Choosing a Medigap Policy
Frequently asked questions
Is there a time of year when I can switch Medigap plans without health questions in Texas?
No. Medicare's fall open enrollment period (October 15 to December 7) doesn't apply to Medigap, and Texas law gives no yearly or birthday switching right. You can switch without health questions only during your Medigap open enrollment period or when a guaranteed-issue right applies.
What is the 30-day right to return a policy?
When you buy a new Medicare supplement policy in Texas, you can return it within 30 days for a refund. If you're replacing a policy, you can keep the old one during those 30 days and then cancel the one you don't want. TDI suggests returning a policy by certified mail with a return receipt.
Can my Medigap company raise my premium?
Yes. TDI explains that companies can raise premiums once a year, and attained-age policies can also go up as you get older. A higher premium doesn't by itself give you a right to switch without health questions.
Will I have a new waiting period for preexisting conditions?
Possibly. Medicare.gov says that if you switch outside your open enrollment period, you may have to wait up to six months before new benefits or your preexisting condition are covered. With a guaranteed-issue right, TDI says companies can't impose preexisting-condition waiting periods.
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