3.2 Kansas Medicare Supplement (Medigap) Regulations
Key Takeaways
The Medigap open enrollment period is the 6 months beginning the first month a person is both age 65+ and enrolled in Medicare Part B.
During open enrollment, insurers must use guaranteed issue: no denial, no surcharge, and no waiting period if the applicant had 6 months of prior creditable coverage.
Guaranteed-issue rights also arise from triggering events (losing group coverage, leaving Medicare Advantage), generally exercised within 63 days.
Medigap plans are federally standardized A–N; Plans C and F are closed to those newly Medicare-eligible on or after January 1, 2020.
Kansas permits issue-age and attained-age rating; rate increases must be filed with KID, and Medigap free look is 30 days.
What Medigap Is
Medicare Supplement (Medigap) insurance is a private policy that fills the gaps in Original Medicare — the Part A deductible and coinsurance, the Part B 20% coinsurance, and similar out-of-pocket amounts. It is sold by private insurers but regulated jointly by federal standardization rules and the Kansas Insurance Department. A Medigap policy is not the same as a Medicare Advantage (Part C) plan: Medigap works alongside Original Medicare, while Advantage replaces it with a managed-care plan. Confusing the two is a frequent exam error.
The 6-Month Open Enrollment Period
The single most tested Medigap rule is the Medigap Open Enrollment Period (OEP): a 6-month window that begins on the first day of the month in which a person is both (1) age 65 or older and (2) enrolled in Medicare Part B.
During this OEP, the insurer must use guaranteed issue:
- No denial of any Medigap plan the insurer offers, regardless of health.
- No surcharge — the applicant pays the same rate as a healthy person.
- No pre-existing-condition waiting period if the applicant had 6 months of prior creditable coverage; otherwise the insurer may impose up to a 6-month waiting period only on the specific pre-existing condition.
This OEP is once-per-lifetime and tied to that age-65/Part-B start — missing it means later applicants can be medically underwritten unless a separate guaranteed-issue trigger applies.
Exam tip: The trigger is age 65+ AND Part B — not the day you turned 65 alone, and not Part A. A person who delays Part B (e.g., still has active employer coverage) does not start the OEP clock until they actually enroll in Part B.
Guaranteed-Issue Rights From Triggering Events
Outside the OEP, Kansas (following federal protections) grants guaranteed-issue rights when specific life events occur. The applicant generally must apply within 63 days of losing the prior coverage.
| Triggering event | Guaranteed-issue right |
|---|---|
| Employer/union retiree group plan ends | Buy Medigap within 63 days |
| Medicare Advantage plan leaves the area or you move out of its service area | Buy Medigap |
| You drop a Medicare Advantage plan during your trial right | Return to Medigap |
| Medigap insurer becomes insolvent or misled you | Switch to a comparable plan |
| You lose Medicaid eligibility | Buy Medigap |
The 12-Month Trial Right
If a beneficiary leaves a Medigap policy to try Medicare Advantage for the first time, they have a 12-month trial period to change their mind. Within that year they can return to their former Medigap policy (or, if unavailable, another plan from the same or another insurer) on a guaranteed-issue basis with no health questions. The trial right exists precisely so first-time Advantage enrollees are not trapped.
Standardized Plans A Through N
Medigap plans are federally standardized, so a "Plan G" sold by any Kansas insurer covers exactly the same benefits as any other insurer's Plan G — only the price and service differ. This is why the exam stresses that you compare Medigap plans on premium, not benefits.
| Plan | Defining feature |
|---|---|
| A | Core benefits only (the baseline every plan must include) |
| B | Core + Part A deductible |
| C | Comprehensive incl. Part B deductible — closed to new-2020 enrollees |
| D | Comprehensive, no Part B excess charges |
| F | Most comprehensive (covers Part B deductible) — closed to new-2020 enrollees |
| G | Like F but does not cover the Part B deductible |
| K | 50% cost-sharing with an annual out-of-pocket maximum |
| L | 75% cost-sharing with an annual out-of-pocket maximum |
| M | Covers 50% of the Part A deductible |
| N | Lower premium with small copays for some office and ER visits |
The 2020 Cutoff (Heavily Tested)
Under the federal MACRA change, Medigap plans that pay the Part B deductible — namely Plans C and F — are closed to anyone first eligible for Medicare on or after January 1, 2020. People already eligible before that date may still buy or keep C/F. For newly eligible beneficiaries, Plan G is the practical top-tier choice because it mirrors F except for the Part B deductible. High-deductible F is likewise closed; high-deductible G remains available.
Rating Methods in Kansas
Kansas permits insurers to price Medigap using either common method, which must be filed with and not disapproved by KID:
| Method | How premiums behave |
|---|---|
| Issue-age | Premium is set by your age when you buy and does not rise simply because you grow older (still adjusts for inflation/trend) |
| Attained-age | Premium rises as you age into higher age bands |
| Community / no-age | Same premium regardless of age (less common) |
Attained-age policies often start cheaper but climb steeply later; issue-age policies lock in a younger rate. Insurers must file rate increases with the Commissioner, and during the OEP and guaranteed-issue events they cannot vary price by health.
Pre-Existing Conditions Summary
| Situation | Pre-existing waiting period |
|---|---|
| During the 6-month OEP, with 6 months prior creditable coverage | None |
| During the OEP, without prior creditable coverage | Up to 6 months on that condition only |
| During a guaranteed-issue triggering event | None |
| Underwritten purchase outside OEP/GI | Insurer may apply a look-back and may decline |
Creditable coverage reduces or eliminates any waiting period day-for-day. Always pair the OEP with the creditable-coverage rule on the exam.
When does the Medigap open enrollment period begin for a Kansas beneficiary?
On the person's 65th birthday regardless of Part B status
The first month the person is both age 65+ and enrolled in Medicare Part B
The first month the person enrolls in Medicare Part A
Whenever the person first applies for any Medigap policy
A Kansan first eligible for Medicare in 2026 wants the most comprehensive Medigap plan she can buy. Which is correct?
She should buy Plan F, the richest plan available to everyone
She should buy Plan C because it covers the Part B deductible
Plans C and F are closed to her; Plan G is her top practical option
All Medigap plans are closed to people newly eligible after 2020
Under Kansas attained-age rating for Medigap, how do premiums behave?
Premiums are locked at the purchase-age rate and never rise with age
Premiums increase as the insured moves into higher age bands
Premiums are identical for every insured regardless of age
Premiums are set entirely by the insured's health status
Sections you finish are checked off in the contents.