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Medigap - Trial Rights 1 and 2
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Important Points
If you enroll in Medicare Advantage when you first turn 65, Trial Right 1 allows you to leave that Advantage plan before the first 12 months are up and switch to a Medigap plan.
If you leave your Medigap plan and switch to an Advantage plan during the Annual Enrollment Period, Trial Right 2 allows you to switch back to the exact same Medigap plan within 12 months of being on the Advantage plan.
Your Trial Rights are limited to certain Medigap plans.
Many Medicare beneficiaries are not aware of their Medigap trial rights. Did you know that there is a 12-month trial right period when you are eligible for Medicare at 65 to try a Medicare Advantage plan?
Let's assume that you find yourself unhappy with your Medicare Advantage plan and you want a Medigap plan but you feel like you have missed your chance. In this case, you have the right to choose to disenroll from your Advantage plan and go to a Medigap plan within your first year or having an Advantage plan that was effective when you turned 65.
If you exercise this trial right and decide to go to a Medigap plan, you will have a Guaranteed Issue (GI) to buy a Medigap plan with no health questions asked. Under this Guaranteed Issue, your application cannot be denied and you cannot be charged a more expensive premium by your Medigap plan. This will also qualify you for a Special Election Period to join a Part D prescription drug plan.
Having a trial period is extremely important for beneficiaries because it allows you to try out a Medicare Advantage plan before being tied to it. However, this is just one of the two trial rights that you can qualify for.
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How Trial Rights 1 and 2 Work
Here are a few examples of how Trial Rights 1 and 2 work:
Trial Right 1: A beneficiary enrolls in a Medicare Advantage plan when they turn 65. The effective date of coverage is June 1st which matches their Medicare Part A and Part B effective dates. In this case, the trial period would end on May 31st of the following year.
In this example. since Part A, Part B, and the Medicare Advantage plan have the same effective dates, the beneficiary will qualify for this trial right. They can pick up a Medigap plan and Part D prescription drug plan in their area without underwriting. Keep in mind that they must apply before their 12 month window is up.
Trial Right 2: During the Annual Enrollment Period a beneficiary leaves his Medigap plan to switch to a Medicare Advantage plan. The Advantage Plan has an effective date of January 1st, and their trial right period will end on December 31st of that year.
In this example, the beneficiary can leave the Advantage plan and rejoin the exact same Medigap plan they originally had within 12 months of being on their Medicare Advantage plan. They must go back to the exact same Medigap plan they had in order to qualify for this trial right.
What Medigap Plans Have Trial Rights?
If you qualify for one of the Guaranteed Issue Trial Rights, you would be limited to certain Medigap plans. For beneficiaries who qualified for Medicare prior to 2020, you can purchase Medigap Plan A, B, C, D, F, K, and L. If a beneficiary qualified for Medicare after January 1st, 2020, then you can purchase Medigap Plan A, B, D, G, K, and L. In certain states, there are insurance companies that will allow you to buy Plan N using Guaranteed Issue.
How are Trial Rights Different from the Annual Election Period?
So how do Trial Rights differ from the Annual Election Period? Trial Rights are for beneficiaries that want to enroll in a Medigap plan but are outside of their Medigap Open Enrollment window. They must have had Medicare Part B for over six months and enrolled in a Medicare Advantage plan for the first time at 65 OR left a Medigap plan for a Medicare Advantage plan for the first time in order to qualify for a Trial Right. Here are a few ways the Trial Rights differ from the Annual Election Period:
The Annual Election Period (AEP) runs from October 15th to December 7th each year.
The Annual Election Period allows beneficiaries to change Medicare Advantage plans, return to Original Medicare and pick up or drop Part D prescription drug coverage. This window does not include Medigap plans.
One-Time Use
Let's assume that you have already used your Trial Right to purchase a Medigap plan. Once you have used your Trial Right, you cannot use it again. For instance, if you used Trial Right 2 to disenroll from you Medigap plan and enroll in a Medicare Advantage plan, and then you go back to your Medigap plan, you can only do this once.
If you want to enroll in a Medigap plan and you do not qualify for these Trial Rights, it is likely that you will need to go through medical underwriting and answer a series of health questions to apply for a Medigap plan.
Summary
Trial Rights are important to you as a Medicare beneficiary. Many people are unaware that these rights even exist. Now that you know more about Trial Rights, we hope we have equipped you with what you need to know when you want to pursue a change in coverage. Our team of Medicare experts are here to answer any of your questions and help you enroll in a plan that is right for you. Contact us today!
Key Points
There are certain requirements you must meet in order to qualify for Trial Rights 1 and/or 2.
If you don't qualify for a Trial Right, you will most likely need to answer health questions in order to apply for a Medigap plan.
You can only use a Trial Right once. It cannot be used again.
At Mohring Insurance Services LLC, we are happy to offer assistance with Medicare when you choose to enroll. Give us a call at (866) 440-1885, or to schedule a free consultation, click the link below:
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