Medicare Supplement Plans for Disabled and Under 65 Individuals in California
This article was updated on: 09/16/2018
Medicare Supplement (Medigap) plans help with out-of-pocket costs you may have in Original Medicare (Part A and Part B) such as copayments, coinsurance, and deductibles. Offered through private insurance companies, these plans may also cover costs not normally covered by Medicare, such as the first three pints of blood in a medical procedure and emergency health coverage when you’re out of the country.
When it comes to Medicare Supplement coverage, most states offer up to 10 plan types. Each plan is labeled with a different letter of the alphabet, and benefits are standardized across each plan type. Plans, benefits, and costs may vary by state and location.
Whether you’re able to get Medicare Supplement insurance is a little more complicated if you have Original Medicare because of a disability. Here’s an overview of how Medicare Supplement plans work if you’re disabled and under 65.
Medicare Supplement plans for disabled, under 65 individuals
Private insurance companies that sell Medicare Supplement plans aren’t required to offer every single plan type. You may not be able to get a Medicare Supplement plan, or you may have limited options, if you’re under 65 and have Medicare because of a disability, amyotrophic lateral sclerosis (ALS), or end-stage renal disease (ESRD).
When it comes to Medicare Supplement plans for disabled, under 65 beneficiaries, state law varies from state to state. Your state may:
- Require private insurance companies to sell at least one Medicare Supplement plan to all beneficiaries under 65.
- Require private insurance companies to offer Medicare Supplement plans to beneficiaries under 65 only if they have end-stage renal disease.
- Require private insurance companies to only sell Medicare Supplement plans to disabled beneficiaries (excluding ESRD).
- Not require private insurance companies to offer Medicare Supplement plans to any beneficiaries under 65, regardless of the reason they have Medicare.
Even if your state requires insurance companies to offer Medicare Supplement plans for disabled, under 65 beneficiaries, you might have more limited options, and you might not be able to get the plan you want. You might need to go through medical underwriting, and you could have to pay more for coverage. Generally, the best time to enroll in a Medigap plan is when you have a guaranteed-issue right because you can’t be turned down for coverage due to health.
Keep in mind that even if your state doesn’t require insurance companies to offer Medicare Supplement plans to younger beneficiaries, some companies may voluntarily do so. Visit Medicare.gov to find out if your state offers Medicare Supplement plans for disabled, under 65 people with Medicare. You can also contact your local State Health Insurance Assistance Program (SHIP) or your state insurance department for more information.
Medicare Supplement plans for disabled, under 65 beneficiaries in California
Private insurance companies are required to offer certain Medicare Supplement plans for disabled, under 65 beneficiaries in California. However, if you’re under 65 and have Medicare because of end-stage renal disease, insurance companies aren’t required under California law to sell you a plan.
California offers special Medicare Supplement protections for younger, disabled beneficiaries. If you have Medicare because of a disability (with the exception of ESRD), you’ll get a Medicare Supplement Open Enrollment Period that starts once you’re enrolled in Part B and lasts six months. If you found out you were eligible for Medicare retroactively, your Medigap Open Enrollment Period begins from the date you got your Social Security letter notifying you that you were eligible.
During your Medicare Supplement Open Enrollment Period, you have a guaranteed-issue right to get any Medigap Plan A, B, C, or F. You may also be able to get Plan K, L, M, or N, if these plans are available; however, the insurance company can choose whether to offer these plans to you. Visit CAHealthAdvocates.org for more information on Medicare Supplement plans in California if you’re under 65; you can also learn about situations when you may have guaranteed-issue rights.
If you have questions about whether you may qualify for a Medicare Supplement plan, I can help. Use the links below to set up a time to discuss your options by phone or receive a personalized email with plan information. Would you rather start browsing now at your own convenience? Just click the Compare Plans button on this page to view plan options in your zip code.