Key Takeaways
- Michigan requires a 6-month open enrollment period for Medicare Supplement starting at age 65
- Guaranteed issue rights apply when losing other coverage or during open enrollment
- Michigan does NOT have a birthday rule like some other states
- Pre-existing condition waiting periods are prohibited during open enrollment
- Medicare Supplement plans must be standardized (Plans A through N)
Michigan Medicare Supplement (Medigap) Regulations
Michigan has adopted federal standards for Medicare Supplement insurance with specific state protections during open enrollment.
Open Enrollment Period
Michigan provides a 6-month open enrollment period for Medicare Supplement:
When It Begins
The 6-month period starts:
- First day of the month you are 65 or older AND
- Enrolled in Medicare Part B
Protections During Open Enrollment
- Guaranteed issue - Must be accepted regardless of health
- No pre-existing condition exclusions
- Standard rates - Cannot be charged more for health conditions
- Any plan available - Can choose any Medigap plan A through N
Important: Michigan does NOT have a "birthday rule" like some states (California, Oregon). Outside of open enrollment, you may face health underwriting when switching Medigap plans.
Guaranteed Issue Rights
Beyond open enrollment, Michigan provides guaranteed issue rights in specific situations:
Triggering Events
| Event | Guaranteed Issue Right |
|---|---|
| Losing employer coverage | Can purchase Medigap within 63 days |
| Leaving Medicare Advantage | Can return to Medigap within 63 days |
| Medicare Advantage plan leaves area | Can purchase Medigap |
| Medigap insurer becomes insolvent | Can switch to comparable plan |
| Losing Medicaid | Can purchase Medigap |
Trial Right
If you leave Medigap for Medicare Advantage:
- Have 12 months to decide if MA is right for you
- Can return to previous Medigap plan
- Or any plan from same insurer
- Guaranteed issue, no health questions
Standardized Plans
Michigan requires Medigap plans to be standardized:
Available Plans
| Plan | Benefits |
|---|---|
| Plan A | Basic benefits only |
| Plan B | Basic + Part A deductible |
| Plan C | Comprehensive (pre-2020 enrollees only) |
| Plan D | Similar to C, no Part B excess |
| Plan F | Most comprehensive (pre-2020 enrollees only) |
| Plan G | Like F without Part B deductible |
| Plan K | 50% cost sharing, out-of-pocket max |
| Plan L | 75% cost sharing, out-of-pocket max |
| Plan M | 50% Part A deductible |
| Plan N | Cost sharing, copays for visits |
Note: Plans C and F are only available to those who became eligible for Medicare before January 1, 2020.
Rate Regulation
Michigan allows different rating methods:
Rating Methods
| Method | Description |
|---|---|
| Attained Age | Premiums increase with age |
| Issue Age | Premium based on age at purchase |
| Community Rating | Same rate regardless of age |
- Insurers can choose their rating method
- Rate increases must be filed with DIFS
- Rates cannot vary based on health status during open enrollment
Pre-Existing Condition Rules
During Open Enrollment
- No pre-existing condition exclusions
- Coverage is guaranteed
- Cannot be charged more for health
Outside Open Enrollment
- Insurers may apply up to 6-month waiting period
- For conditions treated in 6 months before effective date
- Does not apply during guaranteed issue periods
Producer Obligations
When selling Medicare Supplement:
- Must complete Medicare Supplement training
- Must use approved outline of coverage
- Cannot make Medicare/Medicaid comparison
- Must provide required disclosures
Does Michigan have a birthday rule for Medicare Supplement insurance?
How long is the open enrollment period for Medicare Supplement in Michigan?