Medicare Supplement

Turning 65 in Janesville? Your Medigap safety net has a six-month clock

# Turning 65 in Janesville? Your Medigap safety net has a six-month…

Medicare SupplementJanesville, WI

JANESVILLE, Wis. — If you are approaching 65 in Rock County, there is one Medicare rule worth circling on the calendar now: your Medigap Open Enrollment Period. It lasts six months, it starts the month you are 65 and enrolled in Medicare Part B, and it is the only stretch of time when federal law guarantees you can buy any Medigap policy sold in Wisconsin without being turned down or charged more because of your health.

Miss it, and the rules change. That is why local SHIP counselors talk about this window so often — it does not come back around every fall.

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 deductibles. It works alongside Parts A and B, not instead of them.

Federal law gives you one guaranteed shot to buy in. Your Medigap Open Enrollment Period is six months long, and it starts automatically the first month you are both 65 or older AND enrolled in Medicare Part B. You do not sign up for it. It just begins.

During those six months, any insurer selling Medigap in Wisconsin must:

• Sell you any Medigap policy they offer.
• Cover all your pre-existing conditions (though a short waiting period can sometimes apply if you did not have prior creditable coverage).
• Charge you the same price they would charge a healthy person of the same age.

That protection is called "guaranteed issue," and outside of a few special situations, this is the one time everyone gets it.

Why Janesville readers should pay attention now

Janesville sits in Rock County, and like the rest of Wisconsin, residents here have a broad menu of Medigap options to weigh against Medicare Advantage. Wisconsin is also one of three states (along with Massachusetts and Minnesota) that standardize Medigap policies a little differently than the rest of the country, so the plan letters you may read about online do not always map cleanly to what is sold here.

The point: the six-month window is the moment to compare carefully, because your ability to shop freely is at its widest.

What changes after the window closes

Once your six months end, Medigap insurers in most cases can use medical underwriting. In plain language, that means they can look at your health history and decide:

• Whether to sell you a policy at all,
• What to charge you, and
• Whether to make you wait for coverage of a pre-existing condition.

There are a handful of "guaranteed issue" situations later in life — for example, if certain other coverage ends through no fault of your own — but they are narrow. Do not count on them as a backup plan.

This is also why switching from Medicare Advantage to Original Medicare with a Medigap policy years down the road can be harder than people expect. It is legal to try, but the Medigap side may underwrite you.

How Medigap fits with Part D and Advantage

Medigap works with Original Medicare. It does not include prescription drug coverage, so most people who choose this path also enroll in a stand-alone Part D drug plan. A few 2026 Part D facts worth knowing:

• The Part D out-of-pocket cap is $2,100 for 2026.
• The Part D maximum deductible is $615.
• The old coverage gap ("donut hole") is gone as of 2025 — there are now three phases.
• The Medicare Prescription Payment Plan lets you spread drug costs across the year in monthly amounts if you choose.

Medicare Advantage is a different path. You cannot use a Medigap policy with a Medicare Advantage plan. That is one of the biggest decisions to think through during your Initial Enrollment Period around your 65th birthday.

A simple checklist before your window opens

• Confirm the month your Part B coverage starts — that sets your Medigap clock.
• Decide, in broad terms, whether you are leaning toward Original Medicare with Medigap and Part D, or Medicare Advantage.
• If Medigap is on your list, compare policies while your guaranteed-issue rights are active.
• Write down the last day of your six-month window and treat it like a deadline.
• Call Wisconsin's free counseling line before you sign anything.