Who can avail of Medicare Supplement Insurance?

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The short answer is, those who already have Medicare. But the requirements and other circumstances go further. Americans become eligible for Medicare when they turn 65. Moreover, the open enrollment period or the window wherein enrollments in Medigap are welcomed and uniform in premium price regardless of the health of the future policyholder, starts on the first day of the month the latter turns 65. This will be a six-month window thereon.

The Open Enrollment period is crucial for people with health problems. Buying Medicare Supplement Insurance during this time saves a lot on additional premiums insurance companies might charge for those with health problems.

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 Meanwhile, those with health coverage provided by their employer and union might find themselves tempted to avail of a Medigap policy right away. This could be costlier for certain reasons. One is that employer health coverage usually covers benefits similar to those in Medigap. Those with employer health coverage could then defer enrollment in Part B of Medicare (a prerequisite for Medigap) because this will set off the open enrollment period, even when one does not intend to avail of Medigap.

The age exemption for Medicare eligibility applies to those with End Stage Renal Disease (ESRD) and those with Social Security Disability Insurance (SSDI). At this point, however, their purchase of Medigap policies is optional, and insurers are prohibited by law to sell Medigap policies to people below the age of 65.

State Mutual Insurance started out as a group of friends who wanted to give service to the community back in the 1930s. For 70 years, the company has been providing quality Medicare Supplement insurance, following its commitment to give American citizens their right to complete health security. Read more about Medicare Supplement Insurance on this blog.

Medicare Supplement Insurance and pre-existing conditions: Windows of coverage

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A pre-existing condition is a health condition that has been diagnosed prior to the beginning coverage date of a healthcare insurance policy. This is no problem for subscribers to Original Medicare, as this typically does not discriminate against those with pre-existing conditions.

However, pre-existing conditions influence the approval of Medicare Supplement Insurance for applicants, as private companies offer the latter. Moreover, state and national laws give private insurers the right to refuse those with pre-existing conditions, and they can decide in-house on the guidelines and other stipulations governing the treatment of applicants with pre-existing conditions.

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On the other hand, there is such a thing as a Medigap Open Enrollment Period, a six-month duration accorded to those who have turned 65 years of age and enrolled in Medicare Part B to subscribe to any Medicare Supplement Insurance of their choosing. During this window, private insurers cannot refuse policies to those with pre-existing conditions. Neither can they demand higher premiums.

While this window is a generous accommodation, private insurers also reserve the right to delay the coverage of pre-existing conditions for six months, in a process known as a “look-back period” or “pre-existing waiting period.” This means policyholders wait before costs for treatment of priorly diagnosed health conditions can be reimbursed.

It is important to be aware of such windows of coverage to adjust expectations and to make the most of Medicare Supplement Insurance.

Delos Yancey III is the president and CEO of State Mutual Insurance, a legal reserve mutual insurer headquartered in Rome, Georgia. For more information on Medicare Supplement Insurance, visit this