MI Medicare/Medicaid Assistance Program (MMAP)

Volunteer counselors with MMAP answer questions about Medicare, Medicaid, Medigap, or other health care coverage.

To be referred to your local counselor, call:

Common Medigap Questions

Enrollment issues:

1. I need a supplemental insurance policy can I buy a Medigap policy?
   
   You can purchase a medigap policy during your open enrollment period. Open enrollment begins when you turn 65 and enroll in Part B. The open enrollment period lasts for 6 months during this time Federal law states that an insurance company cannot deny you insurance coverage,make you wait for coverage to start or change the price of the policy due to past or present health problems.




Top of Page

2. It is past my open enrollment period can I still purchase a Medigap policy?
   
   In Michigan Medicare beneficiaries can purchase a Medigap policy plan A and C at any time and cannot be denied a policy due to age or health status. The insurance company can impose a waiting period for pre-existing conditions because you are out of your open enrollment period. The waiting period cannot exceed 6 months and must be reduced by anytime you have been covered by another insurance this is call �creditable coverage�.




Top of Page

3. What does creditable coverage mean to pre-existing conditions?
   
   Creditable coverage means you had health coverage six months prior to buying a Medigap policy and had it within the last 63 days. If you have not had coverage in over 63 days you cannot use the coverage prior to the 63 days as creditable coverage. If you had breaks in coverage that lasted over 63 days only the covered days after the 63 days count toward creditable coverage.
   
   For Example:
   Jane Smith 67 is enrolled in Medicare part A and B and has had supplemental health insurance through her husbands past employer. Recently her husband passed away so last month Ms. Smith no longer was eligible for her husband�s retirement health insurance. She can purchase a plan C policy and could be subjected to a wait period for any pre-existing conditions. Since she has not been without coverage for over 63 days and she was covered by health insurance without interruption for years she will not face any waiting period.




Top of Page

4. I am enrolled in Medicare Advantage (Medicare HMO) can I buy a Medigap policy?
   
   No. It is illegal for an Insurance company to sell you a Medigap policy if you are enrolled in Medicare Advantage (Medicare HMO), Medicaid or have another Medigap policy.




Top of Page

5. I have a Medigap policy and just became eligible for Medicaid do I have to keep my Medigap policy?
   
   No. You can suspend your Medigap policy by contacting your insurance company. The insurance company must suspend your policy within 90 days and cannot charge premiums during the time you are eligible for Medicaid. Suspension of a Medigap policy cannot exceed 2 years.




Top of Page

6. I am 54 years old and just became eligible for Medicare I enrolled in Medicare part A & B and have no other health insurance can I purchase a Medigap policy?
   
   Yes. In Michigan insurance companies must sell Medigap plans A and C policies to people under 65 during the special open enrollment period. Medicare Beneficiaries who are below the age of 65 do not have a guaranteed six-month open enrollment period until they turn 65 and are enrolled in Medicare part B your open enrollment will begin. During this open enrollment period you cannot be denied the right to purchase any plan and cannot be charged higher prices but the insurance company can subject you to pre-existing condition waiting period. You will not be subject to a waiting period for pre-existing conditions because you had Medicare A & B (Medicare coverage only counts toward creditable coverage for disabled persons).




Top of Page