There are a number of protections in place for those who are entitled to Medicare and Medigap insurance benefits. Following is an overview of these protections and how Medicare recipients can take advantage of them to obtain top-quality care at a reasonable price.
Medicare Beneficiaries Over the age of 65
The Federal government has created a six month open enrollment period that anyone who turns 65 can take advantage of. During this time, all Medigap plans are available from insurance agencies and these agencies cannot deny you coverage based on your age and/or state of health. What is more, insurance agencies cannot raise premiums for those who have or have had health problems.
After the six months, the open enrollment period is over and you can still purchase Medigap insurance, but insurance companies can either deny coverage or charge more for those who have health problems. However, there are some exceptions where the terms of open enrollment would still apply, such as when your health care provider stops providing insurance or you move to an area that is not covered by your provider.
Medicare Beneficiaries Under the age of 65
Medicare beneficiaries under the age of 65 are not entitled to the same rights as those over the age of 65. Laws vary from state to state and in some cases, Medigap rates can be raised for those who have serious health problems. Alternatively, insurance companies may be able to deny coverage altogether or even refuse to offer one or more Medigap plans.
Thankfully, thirty states in the U.S. do require insurers to offer at least one Medigap plan to those under the age of 65 who are either disabled or have ESRD. What is more, twenty-eight of these states have laws mandating an open enrollment period of Medicare beneficiaries under the age of 65. However, such beneficiaries should note that participation in such open enrollment periods may be limited by the health condition one has. What is more, not all Medigap plans may be made available during such open enrollment periods.
Medigap insurance can offset a lot of medical costs. Those over the age of 65 should have no problem obtaining such insurance at a very reasonable price; however, those under the age of 65 may face a myriad of challenges depending on where they live and their exact state of health. Such individuals are advised to carefully research state laws and look into premium rating rules to ensure that they are getting the Medigap plan that best suits their needs and budget.