It’s not always easy, but it’s certainly possible

If you enrolled in a Medigap policy during your initial six-month window, your plan is guaranteed renewable every year. And since Medigap policies provide standardized coverage regulated by the government, you don’t need to worry about surprise changes to your plan each year. However, if your healthcare needs or income change, you may want to switch plans at some point.

If you’re interested in changing Medigap plans, keep in mind:

• Unlike with Medicare Advantage plans, you aren’t guaranteed the right to enroll in a Medigap policy outside your initial six-month enrollment window. You can still be denied a new policy, even if you’re already enrolled in a Medigap plan.

• When you switch Medigap plans, your new insurer has the right to make you wait up to six months before providing you any benefits that weren’t covered by your old policy.

• Just because the government discontinues your Medigap plan doesn’t mean you need to find a new one. Generally, your plan is still guaranteed renewable without any changes to your coverage, even if it isn’t available to new enrollees.

• You can attempt to switch Medigap plans at any time—you don’t need to wait for open enrollment.

• When you switch Medigap plans, you can take advantage of a 30-day “free look” period. For the first month, you’ll pay premiums for both your old and new Medigap policies. If you find the new plan isn’t for you, you’ll be able to cancel it and go back to your old plan.

For the most part, you’ll have an easier time downgrading Medigap plans—going from a plan with more benefits to one with fewer—than the other way around. It’s also worth checking your local regulations around Medigap. Some states enforce stricter protections for people trying to switch Medigap plans.

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It’s unlikely, but you should still be prepared

Medicare guarantees you certain rights. As long as you pay your premiums, you should be guaranteed the right to all of Medicare regardless of your age, your health, or where you live. Suppose you abide by Medicare deadlines (and pay your premiums). In that case, you should have access to Part D coverage, Medigap, and Medicare Advantage plans as well. However, there are some situations in which you may lose your coverage. Take care to avoid the following:

Failing to Pay Your Premium

Original Medicare is meant to be accessible. Many people are enrolled automatically and have their premiums automatically deducted from their Social Security payments. However, if for any reason you do stop paying your premiums, you will eventually lose your coverage. You’ll receive multiple notices that your bill is overdue. And finally, in about four months after your initial missed payment, Medicare will be able to drop your coverage.

When this happens, you also lose eligibility for Part D. You can re-enroll. Still, you’ll need to wait until general enrollment (January 1 to March 31) to sign up—and your coverage won’t begin until July. Plus, you’ll probably be stuck with higher premiums as a penalty for late enrollment.

Remember that missing any income-related monthly adjustment amounts you owe on Part B or Part D can also lead to loss of coverage.

Committing Medicare Fraud

Medicare fraud can take many forms, including misrepresenting other coverage you have, such as insurance through an employer. Or frauds like allowing someone else to use your Medicare card to access care. The simplest ways to avoid losing your coverage: Be honest, ask questions, and don’t let others use your card to obtain care.

“Disruptive Behavior”

Though Medicare doesn’t go into specifics, you can lose your MA coverage if you behave in a way that “substantially impairs” the plan’s ability to do its job—namely, providing services to you and/or other beneficiaries. While this possibility may sound scary, MA plans must follow specific steps before they can drop you for this reason. MA plans must also provide reasonable accommodations for beneficiaries with mental illness and developmental disabilities. So this particular clause can’t be used to discriminate based on cognitive conditions. Suppose your MA plan does attempt to disenroll you for disruptive behavior. In that case, it must also inform you of your rights to file a grievance. If your MA plan does ultimately drop you, you’ll be put back onto Original Medicare.

What Happens If Your Plan Closes Up?

If your insurance company goes bankrupt or decides to stop dealing with Medicare, you’ll lose that plan’s coverage. However, you’ll receive notice from your company or from Medicare beforehand. You’ll be entitled to a special enrollment period during which you can select a new plan that will kick in when your old plan ends. Your Medicare Advantage, Part D, and Medigap coverage get the same protection.

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Even if you’re still at work, don’t miss your initial enrollment period

Nowadays, many people work beyond the retirement age of 65. Because people live longer and have healthier lives, many are putting off retirement to continue building their savings and collecting work benefits. Although there is a monetary incentive to wait until full retirement age to collect Social Security benefits, most people should enroll in Medicare as soon as they’re eligible. It’s possible to carry both Medicare and private insurance in many cases, thus registering doesn’t have to mean losing the coverage you already have.

Please note that the following information refers to those who are still actively working. Suppose you stopped working but have COBRA when you are eligible for Medicare. In that case, your COBRA coverage will end, and you will need to enroll in Medicare immediately.

Register for Part A

Part A is the most essential part of Medicare and covers hospital-related costs. If you’ve already earned your 40 work credits, which means you’ve paid at least 10 years of Medicare taxes, you’ll get this part without having to pay any monthly premiums.

Since Part A costs nothing, even people still covered by an employer’s insurance plan must enroll during their Individual Enrollment Period. This is the seven-month period that begins three months before your 65^th birthday. Once your Medicare Part A goes into effect, you will have a kind of dual coverage. Any hospital-related care will be covered by your private insurance first and Medicare second.

Although most people will benefit from signing up for Part A as soon as they are eligible, there are two important exceptions:

The first is if you have a Health Savings Account (HSA). If you have an HSA, neither you nor your employer can continue to contribute once you have enrolled in Medicare. So if you want to squeeze in a few more years of HSA savings, it may be in your best interest to postpone enrolling in Part A.

However, keep in mind that the IRS will charge you a tax penalty if you sign up for Part A more than six months after your 65th birthday. When you register, the IRS will consider you retroactively enrolled for the previous six months. This means that you will have to pay taxes on any Health Savings Account (HSA) contributions you have made during that time. To avoid this situation, be sure to stop contributing to your HSA six months before signing up for Part A.

The second exception is when you don’t meet the requirements for premium-free Part A: If you have not earned your 40 work-credits and cannot claim them through your spouse, you will pay a Part A premium. Suppose you are currently working towards those credits. In that case, you will save money by waiting to enroll until you qualify for Part A without paying a premium.

Register for Part B

Part B always has a premium. For most people, it is $135.50 per month. But when you get insurance with an employer that has more than 20 employees. Medicare will allow you to postpone enrolling in Part B without penalty, even if you acquire the insurance through your spouse.

When your employer has less than 20 employees, you will want to enroll in Part B during your Individual Enrollment Period (IEP). You can also keep your employer’s insurance plan. Still, Medicare will become your primary insurer, covering expenses before your private insurance plan takes effect.

If you want to delay enrollment in Part B, please speak with your benefits administrator to determine when to enroll. Some private insurance plans require you to register in Parts A and B to get full coverage through their plan. Your benefits administrator can help you understand how Medicare will work with your current plan. How to reduce your premium and how to ensure you never run out of coverage.

Remember that Medicare will automatically register you in Parts A and B once you turn 65 if you collect Social Security, even if you are still working. If this is the case, you will need to contact your Social Security office to avoid Part B’s automatic enrollment.

Part D, Medicare Advantage, and Medigap

Once you are no longer covered by employer insurance, Medicare will grant you a Special Enrollment Period (SEP) for Part D, Medigap, and Medicare Advantage. During this time, insurers cannot deny coverage or charge you an additional amount based on your age or medical history. Once your special enrollment period ends, there is no guarantee that a private insurer will cover you.

For Part D and Medicare Advantage, your Special Enrollment Period (SEP) lasts for two months after the month your private coverage ends. For Medigap, open enrollment lasts for six months and begins when you sign up for Part B.

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