3.2 Kansas Medicare Supplement (Medigap) Regulations

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.

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.

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:

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

Creditable coverage reduces or eliminates any waiting period day-for-day. Always pair the OEP with the creditable-coverage rule on the exam.