3.2 Indiana Medicare Supplement (Medigap) Regulations

The 6-Month Open Enrollment Window

The single most important Medigap date is the 6-month open enrollment period (OEP). It begins on the first day of the month in which the beneficiary is both age 65 or older AND enrolled in Medicare Part B. During these six months the applicant has full guaranteed-issue rights:

• The insurer must accept the application regardless of health
• No medical underwriting — health questions cannot be used to deny or rate up
• No pre-existing condition waiting period may be imposed
• The applicant may choose any Medigap plan the insurer offers, A through N

Miss this window and the consumer can be underwritten — denied, rated, or made to wait — unless a separate guaranteed-issue trigger applies.

Exam tip: The clock starts at the LATER of age 65 or Part B enrollment. A 67-year-old who delays Part B until retirement gets a fresh 6-month OEP when Part B finally begins.

Indiana's Under-65 Expansion (Effective 2025)

Indiana historically left Medigap access to people under 65 (who qualify for Medicare by disability or end-stage renal disease, ESRD) to insurer discretion. A 2024 law changed that. Effective January 1, 2025, any Medigap plan an insurer sells to age-65 beneficiaries must also be offered — on a guaranteed-issue basis — to Medicare beneficiaries under 65 due to disability or ESRD, each receiving a 6-month guaranteed window tied to their Medicare start. Premiums for Plans A, B, and D must match the age-65 rate; other plans may cost no more than twice the age-65 rate. This is current Indiana law and a likely freshly-updated exam item.

Guaranteed-Issue Trigger Events

Beyond the OEP, federal law (adopted in Indiana) creates guaranteed-issue rights when certain coverage losses occur. The consumer generally has 63 days from the loss to apply:

Trial Right and Free-Look

If a beneficiary drops a Medigap policy to try Medicare Advantage for the first time, the 12-month trial right lets them switch back to a Medigap plan, guaranteed issue, within that first year. Separately, Medigap policies carry a 30-day free look during which the policy can be returned for a full refund.

Standardized Plans A Through N

Medigap benefits are federally standardized: a Plan G from any Indiana insurer covers exactly the same gaps as a Plan G from any other insurer, so consumers compare on price and service, not benefit design. The lettered plans:

The 2020 closure of Plans C and F

Because Plans C and F pay the Medicare Part B deductible, federal law bars them from anyone who becomes newly eligible for Medicare on or after January 1, 2020. Someone who was already Medicare-eligible before that date may keep or still buy C or F; everyone newly eligible after it gravitates to Plan G (identical to F except the beneficiary pays the Part B deductible). The exam loves to ask which plans are "no longer available to newly eligible beneficiaries" — the answer is C and F.

Rating Methods and Rate Filings

Indiana permits insurers to price Medigap using either method, and rate changes must be filed with the IDOI:

• Issue-age rating — premium is based on your age when you buy; it does not rise simply because you grow older (though it rises with inflation)
• Attained-age rating — premium is based on your current age and increases as you age, often cheapest at 65 and most expensive later
• Community rating (no-age) — everyone pays the same regardless of age

Pre-Existing Conditions Outside Protected Periods

When someone applies outside the OEP or a guaranteed-issue trigger, an Indiana insurer may impose a pre-existing condition look-back of up to 6 months:

Prior creditable coverage (e.g., recent employer health insurance) reduces or eliminates the waiting period month-for-month, so a buyer with six prior months of qualifying coverage faces no new wait.