Medicare Supplement

Turning 65 in Auburn? Your 6-Month Medigap Window Starts Now

# Turning 65 in Auburn? Your 6-Month Medigap Window Starts Now

AUBURN, Calif. — If you are approaching 65 in Placer County, one date on your calendar matters more than most people realize. The month you turn 65 and are enrolled in Medicare Part B, a six-month clock starts ticking. During those six months — and generally only during those six months — insurance companies must sell you any Medigap policy they offer, at their best available rate, no matter what health conditions you have.

It is called the Medigap Open Enrollment Period, and it is the one window where federal rules give you guaranteed access to a Medicare Supplement plan. After it closes, the rules change in ways many new enrollees do not see coming.

What the six-month window actually does

Medigap policies — sometimes called Medicare Supplement Insurance — are sold by private companies to help pay costs Original Medicare does not cover, like coinsurance and deductibles. There are standardized plans, labeled by letters such as Plan G and Plan N, and the benefits inside each letter are the same from company to company.

During your Medigap Open Enrollment Period, you have what is called a "guaranteed issue" right. That means any insurer selling Medigap in California must:

• Sell you any policy they offer.
• Charge you the same price they would charge a healthy person of your age.
• Cover you for pre-existing conditions (with limited exceptions if you had a gap in prior coverage).

This window begins automatically the first month you are both 65 or older and enrolled in Medicare Part B. You do not sign up for it. It simply starts — and it does not reset.

What changes after the six months end

Once the window closes, most states allow insurance companies to use medical underwriting when you apply for a new Medigap policy. That means they can look at your health history and decide whether to offer you a plan, at what price, or turn you down.

California has an extra consumer protection called the "birthday rule." Each year around your birthday, you have a 60-day window to switch to a Medigap plan of equal or lesser benefits with the same or another company, without medical underwriting. This is helpful, but it is narrower than the initial six-month window and does not let you move up to richer coverage freely.

Outside these windows, some people qualify for guaranteed issue rights in specific situations — for example, if an employer plan ends or a Medicare Advantage plan leaves their service area. Those are the exceptions, not the rule.

Why the choice at 65 matters long-term

Medigap only works alongside Original Medicare (Part A and Part B). It does not work with Medicare Advantage. If you choose a Medicare Advantage plan when you first enroll and later decide you want to switch to Original Medicare with a Medigap policy, you may face underwriting at that point.

That is why the six months around your 65th birthday are so important. It is not that one path is better than the other — that depends on your health, budget, doctors, and travel needs. It is that the decision you make now affects how easily you can change your mind later.

Auburn is in Placer County, where residents have a range of Medicare Advantage and Part D plan choices during the Annual Enrollment Period each fall. Medigap availability, by contrast, is set by the state and by each insurer's filings, and standardized plan letters look the same whether you live in Auburn, Roseville, or Truckee.

A few 2026 numbers worth knowing

Even if you go with Original Medicare and a Medigap policy, you will still want a Part D drug plan. For 2026, a few program-level figures apply across the board:

• The Part D out-of-pocket cap is $2,100.
• The Part D maximum deductible is $615.
• The coverage gap, or "donut hole," is gone — Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread drug costs across the year in monthly amounts.
• IRMAA income surcharges begin above $109,000 for a single filer.

The Annual Enrollment Period for Part D and Medicare Advantage runs October 15 through December 7. The Medicare Advantage Open Enrollment Period runs January 1 through March 31.

Where to get personalized help

Medigap decisions are personal. Before you sign anything, it helps to talk with someone who is not selling you a plan.

• Medicare.gov has a plan-finder tool and the official "Choosing a Medigap Policy" guide.
• 1-800-MEDICARE (1-800-633-4227) is available 24/7.
• California's SHIP — called HICAP (Health Insurance Counseling and Advocacy Program) — offers free, unbiased counseling by trained volunteers. Placer County residents can reach HICAP through the state at 1-800-434-0222.