By Joy Miller

When first eligible for Medicare, beneficiaries make significant decisions.

Understanding Medicare rules is crucial because opportunities arise as life changes. This year, beneficiaries may have a chance to reconsider which coverage route will work best for them in 2025.

Although there is an annual open enrollment period each fall from Oct. 15 to Dec. 7, only Medicare Part D and Medicare Part C Advantage Plans provide guaranteed issue rights to enroll in a different plan during this period.

Medigap Supplement guaranteed issue rights follow different rules, determined by each state’s department of insurance.

The most advantageous time to purchase a Medigap Supplement policy is during your Medigap Open Enrollment period. This is when you can purchase any policy sold in your state. This 6-month period starts the first month you have Medicare Part B. After this period ends, insurers use medical underwriting to determine acceptance into the plan. In addition, insurers can determine how much a beneficiary will be charged based on health.

There are eight situations in which a beneficiary may have a guaranteed issue right for a Medigap Supplement policy:

• You lose employer group health plan benefits.
• You lost your Medicare Advantage coverage.
• You move out of a Medicare Select Policy’s service area.
• You want to switch from an Advantage plan to Original Medicare (within the first year trial period).
• You move to a Medicare Advantage plan and want to switch back (first time in a Medicare Advantage plan and have been in the plan for less than one year).
• You lose Medigap supplement coverage through no fault of your own.
• Your insurance company commits fraud.
• You lose Medicaid eligibility.

This year, health insurance companies providing Medicare Advantage plans may discontinue plans. If your Medicare Advantage plan is ending, you will receive a Plan Non-Renewal Notice in the mail. This opens a guaranteed issue right to a Medigap Supplement policy if you choose to return to Original Medicare.

The Kansas Department of Insurance provides a Medicare Supplement Shopper’s Guide and an online tool to find estimated premium rates for Medicare supplement plans at insurance.kansas.gov/medicare.

By staying informed and proactive, you can make the most of the open enrollment period and make any necessary changes to your Medicare plan for the upcoming year.

Senior Health Insurance Counseling for Kansans counselors can help by reviewing Medicare notices, explaining coverage changes, highlighting new plan options and offering guidance during the open enrollment period.

If you have a question or to request an appointment, contact the Johnson County K-State Research and Extension Office at 913-715-7000 or Johnson County Aging and Human Services at 913-715-8856.

For more information about Medicare, upcoming Medicare education classes, and SHICK services visit johnson.k-state.edu/programs/home-family/medicare.

Joy Miller is the family and community wellness agent at the Johnson County K-State Research and Extension Office.