3.2 Wyoming Medicare Supplement Regulations

What Medigap Is and Is Not

Medicare Supplement insurance, commonly called Medigap, is a private policy that pays the cost-sharing Original Medicare (Parts A and B) leaves behind: deductibles, coinsurance, and copayments. Candidates must keep three distinctions sharp:

• Medigap supplements Original Medicare; it is not Medicare Advantage (Part C), which replaces Original Medicare with a managed-care plan.
• A person cannot legally hold both an active Medigap policy and a Medicare Advantage plan at the same time. Selling Medigap to someone enrolled in Advantage (outside a valid disenrollment window) is an unlawful sale.
• Medigap generally does not include prescription drug coverage; that comes from a stand-alone Part D plan.

Medigap plans are federally standardized. A "Plan G" sold by any carrier in Wyoming contains exactly the same benefits as a "Plan G" from any other carrier; only price and service differ. This is why exam questions about benefits use plan letters, not company names.

The 6-Month Open Enrollment Period

The single most tested Medigap fact is the Medigap Open Enrollment Period (OEP).

• It lasts 6 months.
• It begins on the first day of the month in which you are both age 65 or older AND enrolled in Medicare Part B.
• It is a one-time, use-it-or-lose-it window that does not reset and cannot be moved.

During this window you have full guaranteed issue rights:

Exam trap: enrolling in Part B is the trigger. Someone who turns 65 but delays Part B (still working with group coverage) does not start the Medigap OEP clock until Part B actually begins.

Standardized Plan Lineup

Wyoming follows the federal standardized lettering. Memorize the role of each tier rather than every cell.

Closed plans: Plans C and F cover the Part B deductible, which Congress barred new plans from covering for anyone newly Medicare-eligible on or after January 1, 2020. Those eligible before that date may keep or still buy C or F. Because F is closed, Plan G is now the most comprehensive option for new enrollees, which is why it is the popular default.

Guaranteed-Issue Triggers Outside the OEP

After the 6-month OEP ends, carriers may normally underwrite. But federal and Wyoming law preserve guaranteed issue in defined situations:

1. Your employer or union group health plan that supplements Medicare ends.
2. Your Medicare Advantage plan leaves the service area or stops serving Medicare.
3. You disenroll from Medicare Advantage within the 12-month trial right after first joining at 65.
4. Your Medigap carrier goes bankrupt or commits misconduct that ends your coverage.

In these cases you generally have a 63-day window from the loss of coverage to buy specified plans without underwriting.

Wyoming's 2025 Birthday Rule

A current update many older study guides miss: in mid-2025 Wyoming adopted a Medigap "birthday rule." Each year, starting on the enrollee's birthday, there is a 63-day window to switch to any available Medigap plan with the same or lesser benefits without new medical underwriting. This lets seniors shop for a cheaper carrier annually. The window is equal-or-lesser coverage only, you cannot use it to upgrade to a richer plan without underwriting.

How Medigap Premiums Are Priced

Candidates should recognize three rating methods, because they change how premiums behave as the insured ages:

Attained-age policies often look cheapest at 65 but become the most expensive later, an important suitability point a producer must disclose.

Selling Standards and Replacement

Wyoming and federal Medigap rules impose strict marketing safeguards:

• A producer must deliver the "Choosing a Medigap Policy" federal guide and an outline of coverage at or before application.
• Duplicate coverage is prohibited, a producer may not knowingly sell a second Medigap policy that overlaps existing coverage.
• Replacement requires a signed replacement notice, and the prior policy should not be canceled until the new one is in force.
• High-pressure tactics, cold-lead advertising, and fear-based selling are unfair trade practices.

Worked scenario

A man turns 65 in March but keeps working and delays Part B until he retires in October. His Medigap OEP starts October 1, not in March, and runs six months through the end of March the next year. Advising him to buy Medigap in March would have been premature, his guaranteed-issue clock had not started. If a producer instead sold him a duplicate or unsuitable plan during that gap, it would violate the duplicate-coverage and suitability rules.