Reviewed for accuracy by Lauri Middleton, RN, MSN, licensed Medicare agentReviewed for clarity by Karen OrillaMeet our reviewers →
Medigap — Medicare Supplement insurance — is a private policy that pays some of what Original Medicare leaves for you to pay, such as the 20% coinsurance. Plans are standardized by letter, so a Plan G from one company covers the same things as a Plan G from another; only price and service differ. It works only with Original Medicare, not with Medicare Advantage. Your best guaranteed chance to buy one is the six months after Part B starts.
Apply this to my situationThe rules behind this
Medigap fills Original Medicare’s gaps — and has its own six-month window
A Medigap (Medicare Supplement) policy is private insurance that pays some of what Original Medicare does not, such as coinsurance and deductibles. Plans are standardized by letter. Your best guaranteed chance to buy one is the six months starting when you are 65 or older and enrolled in Part B; after that, an insurer can often ask health questions and charge more or refuse.
Who this is for
People choosing Original Medicare.
What changes it
- Medigap cannot be used with a Medicare Advantage plan.
- California adds its own rights; see the California rules.
The question that settles it
“When does my six-month Medigap open enrollment start and end?” — HICAP or the California Department of Insurance.
California’s birthday rule: a yearly chance to change Medigap plans
In California, people who already have a Medigap policy get a yearly window beginning on their birthday — at least 60 days — to switch to another Medigap plan with equal or lesser benefits, from any insurer, without health questions.
Who this is for
California residents who already hold a Medigap policy.
What changes it
- It does not let you move to a plan with more benefits without health questions.
- It does not apply to people in Medicare Advantage.
The question that settles it
“Under California’s birthday rule, which plans can I switch to this year and by what date?” — California Department of Insurance or HICAP.
Source: California Department of Insurance — Medicare Supplement Insurance ↗
Get help
Free Medicare counseling
California HICAP offers free, confidential Medicare counseling. Ask the local program about language and appointment availability.
California HICAP1-800-MEDICARE
Call 1-800-MEDICARE and ask for an interpreter. TTY: 1-877-486-2048.
Call Medicare · 1-800-633-4227Official information in other languages ↗External resource. Some pages are in English; ask for language assistance if needed.