Putting Medigap on Hold When You’re Under 65
This article was updated on: 09/16/2018
If you’re not yet 65 but are enrolled in Medicare, and you have a Medicare Supplement (Medigap) plan, you may be able to temporarily leave your Medigap plan.
Some people may qualify for Medicare before 65 if they get disability benefits for 24 months or have certain conditions, like amyotrophic lateral sclerosis (ALS) or end-stage renal disease (ESRD). Under federal law, Medicare beneficiaries under age 65 have the right to suspend Medigap policy benefits and premiums (put them on hold), without penalty, if they have coverage through an employer group health plan. This right helps you if you’re still working: you can take advantage of all your employer benefits without having to give up your Medigap policy permanently.
If you have Medicare and you’re under 65, you can suspend your Medicare Supplement policy at any time while you have employer group health insurance. In order to suspend your Medigap policy, you must call your Medigap insurance company and let them know that you want to suspend your benefits and premiums.
If you lose your employer group health plan coverage, you can get your Medigap policy back. Please keep in mind that:
- Within 90 days of losing your employer group health plan coverage, you must tell your Medigap insurance company that you want them to reinstate your policy.
- The Medicare Supplement policy must have the same benefits and premiums as it would have had if you had never suspended your coverage.
- Your Medigap insurance company may not refuse to cover services for any pre-existing health conditions you have.
- Your Medigap benefits and premiums will start the same day your employer group health plan coverage ends.
The rules may vary depending on which state you live in. Some states might offer this right to beneficiaries aged 65 or over; check with your state insurance department. Also, in some state insurance companies are not required to sell Medicare Supplement plans to persons under 65.
Rules concerning Medicare Supplement insurance may be subject to change. Be sure to contact your insurance company to understand the details before you suspend your Medigap policy.
I may be able to help you with any questions you have about Medigap policies or other Medicare plans. Please feel free to view my profile by clicking the “View profile” link below. I’d love to explain your choices to you by phone, or email you some Medicare plan information — just follow the links below to set that up. Want to start looking at your Medicare options right away? The Compare Plans button lets you do just that.