Missouri Anniversary Rule

Medicare in Missouri

The St. Louis Arch in Missouri will always be considered a gateway to the west. It is no surprise that many people also consider Missouri the gateway to retirement! A large portion of the state’s population includes Medicare beneficiaries. Missouri is actually one of few states that has enacted legislation to protect it’s Medicare beneficiaries with state-specific Medigap rules.

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Missouri Medicare Open Enrollment

Missouri is very similar to other states in that beneficiaries who are new to Medicare are offered an open enrollment window. Whether you are turning 65, or delayed your Medicare enrollment due to creditable health care coverage, when you enroll in Medicare Part B you will be given a 6 month open enrollment window for Medicare Supplement plans. During this window you can enroll in a Medigap plan without having to undergo medical underwriting or answer any health questions.

part-b-open-enrollmentYour Medicare Part B effective date essentially starts a ticking time clock to enroll into a Medicare Supplement plan without medical underwriting. During this time, you cannot be denied coverage due to pre-existing conditions or health history. Once this 6-month window ends, if you want to apply for a Medigap plan, you will be subjected to medical underwriting. This means that insurance carriers can deny you coverage based on your health or prescription history. For this reason, it is critical to enroll into a Medicare Supplement plan during your open enrollment window.  

Can I Change My Medigap Plan in Missouri?

One of the most important reasons to enroll in a Medicare Supplement plan during your open enrollment window has to do with changing your plan in the future.

If you do not have a Medigap plan in Missouri and you want to enroll in a plan past your open enrollment window, you must undergo medical underwriting. This means that the insurance carriers will assess your medical history including diagnoses, prescriptions, hospitalizations, height and weight, and other health-related factors. Then, the insurance carrier can decide whether to approve or deny you for a Medigap plan at their discretion. 

However, if you do have a Medigap plan in Missouri, there is a rule in place that gives you the ability to change your Medicare Supplement plan once per year, without having to undergo medical underwriting. If you qualify for the Missouri Anniversary Rule, insurance carriers must accept you into their plan, regardless of your health history.

So, what is the Missouri Anniversary Rule?


Missouri Anniversary Rule

The Missouri Anniversary Rule is a Medicare Supplement rule specific to the state of Missouri that allows Medicare beneficiaries enrolled in Medigap plans to change their plan without undergoing medical underwriting. This is an extremely important rule as it allows enrollees to be able to consistently shop plans and lower their premiums even if they have pre-existing conditions or a significant health event.

In order to utilize the Missouri Anniversary Rule, you must meet certain criteria:

Who Can Change?

In order to qualify for this rule, you must be currently enrolled in a Medicare Supplement plan. If you are enrolled in a Medicare Advantage plan or do not have any supplemental coverage, you will not qualify for the Anniversary Rule. As long as you are enrolled in a Medigap plan A-N, you will qualify, but the plan you have will impact the moves you are able to make.

When Can I Change?

The best part about the Anniversary Rule is that the name tells you exactly when you can make a move. It makes it hard to forget! In Missouri, every year starting 30 days before your policy anniversary date and ending 30 days after your policy anniversary date, you can utilize this rule to change your plan. You are allotted a 60 day window to make the change, and the window happens every year at the same time.

What Changes Can I Make?

The Anniversary Rule allows you to change your Medigap plan to one of equal or lesser coverage without any medical underwriting. To put it simply, you can change to a plan with equal benefits or a plan with lesser benefits, but you cannot change to a plan with higher benefits. If you want to increase your benefits, you would have to undergo medical underwriting. 

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