Medicare Supplement

Turning 65 in Hudson? The Medigap rule that only works once

HUDSON, N.H. — If you are approaching 65 in Hudson, there is one Medicare rule worth writing on the calendar in permanent marker. It is the six-month Medigap Open Enrollment Period, and it is the only stretch of time when federal law guarantees you the right to buy any Medigap policy sold in New Hampshire — at the best available price for your age — no matter what your health looks like.

Medicare SupplementHudson, NH

Miss it, and the rules change in ways many people do not learn about until they try to switch later.

What the six-month window actually is

Medigap — also called Medicare Supplement Insurance — is a private policy that helps pay some of the out-of-pocket costs Original Medicare leaves behind, like coinsurance and copays. It only works alongside Original Medicare (Part A and Part B), not with a Medicare Advantage plan.

The Medigap Open Enrollment Period begins the first month you are both 65 or older AND enrolled in Part B. It lasts six months. That is it. It does not repeat every year, and it does not reopen if you change your mind later.

During those six months, federal law gives you what is called a "guaranteed issue" right. An insurer selling Medigap in New Hampshire must sell you any policy it offers, at the same price it charges other people your age, and cannot make you wait for coverage of a pre-existing condition beyond the limited exclusion period allowed by law.

Why this window matters more than people realize

Outside of that six-month window, in most situations, Medigap insurers are allowed to use something called medical underwriting. That means they can look at your health history and decide whether to sell you a policy, what to charge, and whether to attach conditions.

In plain terms: if you develop a health issue at 68 and then decide you want a Medigap policy, the insurer can say no, or offer you a policy at a higher price. There are a handful of narrow "guaranteed issue" situations later in life — for example, if certain coverage you had ends through no fault of your own — but they are exceptions, not the rule.

That is why the initial six months carry so much weight. It is the one time the door is guaranteed to be open.

How this fits with the choice between Original Medicare and Medicare Advantage

Hudson is in Hillsborough County, where residents can choose between staying with Original Medicare (often paired with a Medigap policy and a standalone Part D drug plan) or enrolling in a Medicare Advantage plan that bundles coverage together.

Here is the part that trips people up: if you sign up for a Medicare Advantage plan at 65 instead of buying Medigap, you generally use up — or never use — your one guaranteed Medigap window. If you later want to leave Medicare Advantage and go back to Original Medicare with a Medigap policy, you will usually face medical underwriting.

There is a limited exception often called a Medigap "trial right" if you try Medicare Advantage for the first time and switch back within 12 months. It is worth asking about before you decide.

None of this means Medicare Advantage is a bad choice or Medigap is a better choice. It means the decision you make at 65 has a longer shadow than a single year of coverage.

What to think through before your window closes

A few practical questions to work through during those six months:

• Do you want the freedom to see any provider in the country who accepts Medicare, which is how Medigap plus Original Medicare works?
• Or do you prefer the bundled structure of a Medicare Advantage plan, which typically uses networks?
• If you choose Medigap, which of the standardized letter plans (like Plan G or Plan N) fits your budget and how you use care?
• Have you compared premiums from more than one insurer? Medigap plans with the same letter cover the same core benefits by law, but premiums can differ between companies.

If you take one thing from this article, take this: do the comparison shopping before the six months end, not after.

Where to get unbiased help in Hudson

You do not have to figure this out alone, and you do not have to rely on a sales call.

• medicare.gov lets you compare Medigap policies available in New Hampshire by ZIP code.
• 1-800-MEDICARE (1-800-633-4227) is staffed 24/7.
• ServiceLink is New Hampshire's State Health Insurance Assistance Program (SHIP). Its counselors offer free, one-on-one Medicare guidance, and there is a ServiceLink Resource Center serving the Hudson area.