Under Age 65 Medicare Supplement (Medigap)

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There are 30 states which offer Under-Age 65 Medicare Supplement plans:  California  –  Colorado,  –  Connecticut (plan A only)  –  Delaware  –  Florida  –  Georgia  –  Hawaii  –  Illinois  –  Kansas  –  Louisiana,  –  Maine  –  Maryland (plans A & C)  –  Massachusetts  –  Michigan  –  Minnesota  –  Missouri  –  Mississippi  –  Montana  –  New Hampshire  –  New Jersey  –  New York  –  North Carolina  –  Oklahoma (plan A only)  –  Oregon  –  Pennsylvania  –  South Dakota  –  Tennessee  –  Texas (plan A only)  –  Vermont  –  Wisconsin.

If you are under age 65 and disabled, you may be eligible for a Medicare Supplement (Medigap) policy of your choice.  Medicare Supplement policies are purchased when an individual becomes eligible for Medicare Parts A and B.  Once your Medicare coverage starts, you will have an “Initial Open Enrollment” period (six months from the time your Part B coverage starts), this is a “guaranteed-Issue”  time frame where you are guaranteed coverage regardless of your current or previous health status.  You can purchase any Medicare Supplement policy from any company offering under age 65 Medigap plans in your state.  Also, be aware you have 3 months to enroll in a Medicare Part D plan, once your Medicare Part B starts.

If you have been on Medicare for longer than 6 months and are not in a “Guaranteed-Issue” period, you will most likely not be eligible for a new Medicare Supplement (Medigap) policy.  California, Oregon and Missouri are the only states which offer an “annual open enrollment” period, which allows you to move to a new company if you already have a Medicare Supplement.

Under-Age 65 with ESRD … If you are under age 65 and are now on Medicare because of ESRD (End Stage Renal Disease), many states will allow you to enroll in a Medicare Supplement plan, although Medicare Advantage companies will not.  If you have an employer health insurance plan or currently on a Medicare Advantage plan you may have opportunities for continued Medicare Advantage coverage.  Under-age 65 with Medicare and ESRD may work differently than a person 65 or over with Medicare and ESRD, depending on your state of residence.  Contact me and we can see what is available to you.

Disability .. When Does Medicare Start?  People who can establish that they suffer from long-term disabilities that prevent them from working can qualify for monthly Social Security disability insurance (SSDI) payments and Medicare.  Individuals who file for social security disability benefits and are approved will be eligible at some point to receive medicare benefits, usually after 24 months.  Individuals who are approved for SSI disability will initially receive Medicaid.

2 Years … To receive Medicare benefits you will have to wait two years after the first date that you are entitled to receive a Social Security disability benefit.  Unless you have insurance currently, this means you may be without health insurance coverage for up to two years.  If you do have health insurance, do NOT cancel it when you first learn that you have been approved for Social Security disability, until you know when your Medicare coverage will begin.

Medicare Part B Effective Date … If you currently have an employer group health plan or union plan you do not have to enroll in Medicare’s Part B plan.  When you know the plan will end you can call the Social Security office near you (800-772-1213) and tell them you are ready to start your Part B coverage.  They can send you the appropriate paperwork to get you started.

Open Enrollment Rights for Disabled Persons … Disabled beneficiaries who are covered by Medicare before age 65 can use the Open Enrollment period again after attaining age 65 to apply for a new Medicare Supplement (Medigap) policy with the same or a different insurer.  The benefits of reapplying after attaining age 65 may include: 1) getting better rates for the same policy from the beneficiary’s current insurer; 2) switching to an insurer not available to the beneficiary when he/she was under age 65; and 3) upgrading benefits while getting the “best rate” offered to all individuals over 65.

 

111 thoughts on “Under Age 65 Medicare Supplement (Medigap)

  1. Kim

    Are there any Medigap policies in California that will accept a person under 65 who is still disabled and has had a kidney transplant? Are there any that will accept an ESRD patient?

  2. John Post author

    Hello, unfortunately, under age 65 Medicare Supplement policies are not available in Nevada. Not all states provide for folks on SS and under age 65. The only available options are to either move to a state like CA or CO, or keep original Medicare, or choose one of the available Medicare Advantage plan in your County.

    I hope that helps. Thank you .. John Conner

  3. Jenny

    Hi John,
    I have a friend looking for a supplement for his wife who’s 52 and on Medicare disability… we are in NV. Any suggestions? I’m getting conflicting information on the web and not sure where to look. Thank you!

  4. John Post author

    Hi RG, that is correct, Alabama is not an “under-age 65″ Medicare Supplement State. Unfortunately at this time you cannot enroll in a Medicare Supplement until your next open-enrollment which is at age 65.

    Thanks RG.

  5. RG Kilpatrick

    Dear Mr. Conner
    I am 62 years old, been on Social Security Disability since 2001 and Medicare since 2002. I have started looking for a Medicare Supplement Policy (Medigap ) and was told today by Humana that Alabama does not participate in a Medicare Supplement under 65 year old by any insurance company. Can you validate this to be correct? Thank you in advance for your help.

    RG Kilpatrick

  6. Diane Lehman

    My husband has been on disability for 2 years in May from a liver transplant, he just received his notice that he will be on medicare as of 5/14. He buys his own plan now and it $425 a month he was told by blue cross that in may he needs to buy a supplemental insurance policy should he also pay for medicare part b? He is 52 years old and we live in Mi…

  7. John Post author

    Hi PJ, you are looking at approx, $300/mo for a plan C and $15/mo for a plan A. You are right, plan C will cover both deductibles which is nice so you have to do a little calculation which will be a better financial deal through the next few years. Remember the Hospital deductible (A) is a 60 day deductible, not annual like the Part B deductible. If a doctors does not accept medicare or no longer accepts new Medicare patients you will not be able to see that doctor even with a Med Supp.
    Hope that helps. Let me know if you have any questions. Thanks .. John Conner.

  8. PJ

    Dear John ~
    Thank you ever so much for your reply. Zip code is 20850. Two other questions: I’ve always bought the “best PPO plan” when employed so I had best, most expansive options. For a Med Supp plan since A&C are my only options. Say from Company X, plan A is $2,023 and plan C is $ $4,744. The big difference in plan C is to cover hosp & part b deductible totaling $1,331/yr, and cost of C is $2,721 higher ~ Would it be a good decision to go with plan A? Question #2 – I’m lost about when a medical provider does not accept Medicare, does that mean even with a Medicare Supp plan I can’t see them anymore or would have to pay entire cost out of pocket?
    Again, thank you more than I can say!!!!!!

  9. John Post author

    Hello, yes Maryland is a Medicare Supplement plan A & C only state for folks under age 65 and on Medicare. Plan C is very comprehensive, the only coverage missing is called Excess Charges coverage. In most cases the excess charges are a few bucks here or there, but you do have to be aware of how it works. Medicare PPO plans can work pretty well, but don’t compare to Med Supps in coverage and access to different doctors and hospitals. What is your zip code and I’ll email you the available Medicare Supplement companies and rates.

    Thanks .. John Conner

  10. PJ

    Dear Mr. Conner ~
    I am so appreciative of finding you site and that you offer advice to people out of state. I like all the others am so lost despite lots of reading. I am 62 just got Medicare A&B in Oct d/t disability. Live in MD. Was told by a SHIP advisor that “F” plans are best but as I am not 65 can only buy an A or C Medigap plan. Not sure this is true? Also I understand all benefits are the same under each letter plan ~ is it any better to buy a more “known” name such as Aetna or State Farm? Lastly, is you want to see a medical professional who doesn’t participaate in Medicare is ther any way Medigap would pay some as in a PPO? Thanks a million may your goodwill come back to you !

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