What is the Medigap Open Enrollment Period?

The Medigap Open Enrollment Period is a one-time, 6-month window that begins the month you are both 65 or older and enrolled in Medicare Part B. During this window, insurers must sell you any Medigap plan they offer at standard rates regardless of your health history. Once it closes, you generally lose guaranteed-issue rights and can be medically underwritten or denied.

Can I switch Medigap plans after my Open Enrollment Period?

In most states, switching Medigap plans after your Open Enrollment Period requires passing medical underwriting — you can be charged more or denied based on health history. Some states have additional protections: birthday rules (California, Oregon, Idaho, Illinois, Nevada, Louisiana), continuous open enrollment (New York, Massachusetts, Connecticut, Maine), and anniversary rules. The Medigap Specialist maps your state's specific rules.

What is the difference between Medigap Plan G and Plan N?

Plan G covers the Medicare Part B excess charges that Plan N does not. Plan N requires copays of up to $20 for office visits and $50 for emergency room visits. Plan G typically has a higher premium but lower out-of-pocket costs for frequent users. The right choice depends on your health utilization, your state's excess charge rules, and your risk tolerance.

What are Medicare excess charges?

Medicare excess charges are the difference between what a provider charges and the Medicare-approved amount, up to 15% above the approved rate. Providers who do not accept Medicare assignment can charge these. Eight states prohibit excess charges entirely. If you are in a state that allows them and see non-participating providers, Plan G protects you; Plan N does not.

Is the Medigap Specialist tool free?

Yes. The Clearing Medigap Specialist is completely free, requires no account, and produces no quotes or carrier recommendations. It maps your situation to the federal rules and state protections that apply — nothing more.

What is a Medigap birthday rule?

A birthday rule is a state consumer protection that gives Medigap enrollees a window each year around their birthday to switch to an equal or lesser Medigap plan without medical underwriting. States with birthday rules include California, Oregon, Idaho, Illinois, Nevada, and Louisiana. The specific window and eligible plans vary by state.

What does Medigap medical underwriting mean?

Medical underwriting means an insurer reviews your health history before deciding whether to sell you a Medigap policy and at what price. Outside your Medigap Open Enrollment Period, most states allow insurers to deny coverage, charge higher premiums, or impose waiting periods based on pre-existing conditions. Guaranteed-issue rights — which prevent underwriting — apply only during specific federal and state-defined windows.

Medigap Specialist · Your Review

Your Medigap situation, in plain English.

Five short questions. A free review of what matters for your situation — and what you can set aside for now. No quotes, no carrier recommendations.

About 4 minutes No personal information collected No quotes, no carrier recommendations

Medigap is not just one decision.

Most people approach Medigap as a single choice. It's actually three questions — and which one matters most depends entirely on where you are right now.

Can I get in? Open enrollment, guaranteed issue, underwriting — which applies to you.

Can I keep it? Premium structure, rate history, and what could make this harder to afford later.

Can I change it later? Switching rights, state rules, and what your options look like if something changes.

Not every Medigap rule matters to every person. The purpose of this tool is to help you identify which rules may matter for your situation right now — and which ones you can set aside until they become relevant.

This tool does not quote prices, rank carriers, or recommend a plan. It is an education tool — not a sales tool.

Question 1 of 5

What state do you live in?

Your state can affect Medigap protections, switching options, and pricing rules. We'll show only the rules that may matter for your situation.

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Question 2 of 5

What is your current coverage situation?

This determines which set of federal rules and enrollment windows apply to you.

Question 3 of 5

Which of these is closest to where you are right now?

Pick the one that fits best. If none fits exactly, choose the closest — you'll have a chance to add context at the end.

Question 4 of 5

Are you enrolled in Medicare Part B?

Part B enrollment is what triggers your Medigap open enrollment window. The 6-month window starts the month your Part B begins — not your birthday.

Question 5 of 5

Where are you in the decision timeline?

This calibrates the urgency of your enrollment window and what actions matter most right now.

Medigap Specialist · Your Review

Your Medigap Situation Review

Based on your answers — here’s where you stand, what to verify, and what you can set aside for now.

Prepared today Five-question intake Your state

Free Snapshot Here are the flags.

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Member Full Review Let’s work through them and document your decision.

Your pathway Open Enrollment Window

Your enrollment pathway Open Enrollment Window

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What this means: Your result does not mean you should or should not choose a specific policy. It means these are the areas to verify before relying on the ability to buy, switch, or replace Medigap coverage later. State rules and federal windows change — confirm current rules before acting.

Based on your answers — verify these first

Your State Protections

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Standard

Three Things That Sound Right — But Aren't

These three misconceptions cause more Medigap regret than any other factor. They apply to every situation.

Red Herring 1

"The lowest premium must be the best choice."

A lower premium may look attractive, but you still need to check rate history, household discount rules, future switching rights, and whether you could change later if costs rise. The premium you see today is not the only cost that matters.

Red Herring 2

"Medicare Open Enrollment means I can change anything later."

Medicare's annual Open Enrollment Period does not automatically create a broad federal right to switch Medigap policies without underwriting. Those are different windows, governed by different rules. Confusing them is one of the most common and costly mistakes.

Red Herring 3

"I can try Medicare Advantage first and get Medigap later if I change my mind."

You may have certain trial rights, but after those windows close, getting Medigap later may depend on your state's rules, your timing, and whether you can pass underwriting. This is not a guaranteed option — it is a situation-specific one.

What You Can Set Aside For Now

Not every Medigap rule matters at every stage. Based on your situation, these are the areas you do not need to focus on right now.

Before You Act

These are the steps that protect you. Check each one before dropping any existing coverage or signing a new policy.

Verification Checklist Check each item before signing or dropping existing coverage

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Confirmed my Part B enrollment date — my Medigap open enrollment window starts the month Part B begins
Verified my state’s consumer protections with my state Department of Insurance (not just an agent’s description)
Confirmed the carrier’s pricing model (community-rated, issue-age, or attained-age) in writing
Looked up the carrier’s AM Best rating at ambest.com
Confirmed the plan is an open block — the carrier is actively enrolling new members
Confirmed Part D drug coverage is separate — Medigap does not cover prescriptions
Confirmed I am NOT dropping existing coverage until the new policy is confirmed active
Spoken with a SHIP counselor or verified my situation at medicare.gov before signing

Your Full Medigap Future Choice Review

Let’s work through the flags and document your decision.

Deeper state rule explanation

Carrier Review Scorecard (4 factors)

Underwriting screener (if applicable)

Plan G vs. N vs. G-HD guidance

Agent disclosure checklist

Affordability comfort worksheet

Personalized question scripts

MA exit review (if leaving Advantage)

Final option comparison

Verification log

Annual monitoring plan

Downloadable PDF packet

“The Snapshot identified what matters. The Full Review helps you work through it, document it, and return to it when things change.”

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What's next

Three options worth knowing.

If yours feels different — or you want to go deeper — here are three options worth knowing about.

Free SHIP counseling

SHIP counselors are trained, state-funded, and have no financial stake in your decision. They can answer questions specific to your situation at no cost.

Find your state’s SHIP program → shiphelp.org

Fern — The Clearing’s AI navigator

If your situation is more complex, or you want to work through the details without a sales pitch, Fern can help. Fern doesn’t sell policies. She helps you understand your options.

Talk to Fern →

Tell us more — refine your result

Not sure which situation applies to you? Describe what feels different in a sentence or two. We’ll point you toward the right next step.

Save your Medigap review

Your result is saved at a private link — no account required. Bookmark it or share it to return any time for the next 8 months.

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Companion guide

Read the full Medigap guide

15 pages, fillable checklists — free, no email required.

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