Definition. Medigap Open Enrollment is a one-time, six-month window that starts the first month you're 65 or older and enrolled in Part B. During it, a company can't refuse to sell you any Medigap policy it offers or charge you more because of your health.
What it means
During your Medigap Open Enrollment Period:
- A company can't deny you any Medigap policy it sells.
- It can't charge you more because of past or present health problems.
- It can't make you wait for coverage of a pre-existing condition if you had at least six months of prior creditable coverage; with less, the wait is shortened by the coverage you had.
The window can't be repeated or moved. After it ends, outside a guaranteed-issue situation, companies may use medical underwriting. If you delay Part B because you have job-based coverage from current work, the window starts when your Part B starts.
In Oregon
Oregon adds three protections (Division of Financial Regulation rules, OAR chapter 836, division 52):
- Under 65: a six-month open enrollment starting when you enroll in Part B, with every plan the company sells and a premium no higher than it charges people who are 65; people who enrolled in Part B before 65 get a second open enrollment at 65 (OAR 836-052-0138).
- Moving to Oregon on disability Medicare: if you come from a state that doesn't require under-65 Medigap, you have 63 days from establishing Oregon residency to buy a policy with guaranteed issue.
- Birthday rule: once you have a Medigap policy, you can switch to one with the same or lesser benefits from 30 days before to 30 days after your birthday each year (OAR 836-052-0143).
Find your yearly window with the birthday rule timing tool.
Sources
- Medicare.gov — When can I buy Medigap?
- Oregon Administrative Rules 836-052-0138 — Open enrollment
- Oregon Administrative Rules 836-052-0143 — Annual opportunity to select another Medicare supplement policy
Frequently asked questions
If I delay Part B because I'm still working, when does my Medigap Open Enrollment start?
It starts the month your Part B begins, not at 65. If you delay Part B until you retire at 67, your six-month window opens when your Part B starts.
I'm under 65 and have Medicare because of a disability. Do I get Medigap Open Enrollment in Oregon?
Yes. Oregon gives you a six-month open enrollment when you enroll in Part B, with every plan the company sells and a premium no higher than it charges 65-year-olds. You get another open enrollment when you turn 65.
What happens after my Medigap Open Enrollment ends?
Companies can use medical underwriting unless you have a guaranteed-issue right. In Oregon, if you already have Medigap, the birthday rule lets you switch each year to a policy with the same or lesser benefits without health questions.
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