The best time to enroll in a Medigap (Medicare Supplement) policy is during your one-time 6-month Medigap Open Enrollment Period, which starts the first month you are 65 or older and enrolled in Medicare Part B. During this window, insurers cannot deny coverage or charge higher premiums due to pre-existing health conditions.
The best time to buy a Medigap policy is during your Medigap Open Enrollment Period. This is the 6-month period that starts the first day of the month you're 65 or older and signed up for Part B. After this period, your options to buy a Medigap policy may be limited and the policy may cost more.
Insurance companies set prices for Medigap policies in 1 of 3 ways: Attained-Age Rating — This is the most common way policies are priced in California. Attained age-rated policies increase in price as you age, because as you get older, you typically require more health care.
You should apply for Medicare during your 7-month Initial Enrollment Period (IEP), which starts 3 months before your 65th birthday month, includes your birthday month, and ends 3 months after. Applying in the first 3 months ensures coverage starts the first day of your birthday month, preventing gaps or penalties; if you're already getting Social Security, you're often automatically enrolled.
Q: What is the "Birthday Rule" and how does it apply to the new Medigap Plans? A: If you already have Medigap insurance, you have 60 days of "open enrollment" following your birthday each year when you can buy a new Medigap policy without a medical screening or a new waiting period.
Yes, you can apply for Medicare Supplement (Medigap) plans anytime if you have Original Medicare (Part A & B), but your best time is during your 6-month Medigap Open Enrollment Period (starting when you're 65 and enrolled in Part B) for guaranteed acceptance; otherwise, insurers can deny coverage or charge more based on your health. Outside of that period, you can still enroll, but you'll need to answer health questions, and coverage isn't guaranteed unless you qualify for a "guaranteed issue right".
Medigap Premium Increases
Attained-Age plans typically experience premium increases as the policyholder gets older, while Issue-Age plans may experience premium increases due to inflation and other factors. Community-Rated plans may also experience premium increases due to inflation, but not due to age.
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Generally, you're first eligible to sign up for Part A and Part B starting 3 months before you turn 65 and ending 3 months after the month you turn 65. (You may be eligible for Medicare earlier, if you get disability benefits from Social Security or the Railroad Retirement Board.)
Plan G remains the most popular Medigap plan for new enrollees, offering comprehensive coverage with predictable costs. Other popular plan options include High-Deductible Plan G, Plan N, and Plan F (if eligible).
The standard monthly premium for Medicare Part B enrollees will be $185.00 for 2025, an increase of $10.30 from $174.70 in 2024. The annual deductible for all Medicare Part B beneficiaries will be $257 in 2025, an increase of $17 from the annual deductible of $240 in 2024.
You will typically pay less for an issue-age-rated plan if you enroll in the plan when you're younger. Your premiums also won't increase based on your age. Attained-age-rated Medigap plans set their premiums based on your current age. As you age, your Medigap plan premiums will gradually increase each year.
The "best" Medicare plan for seniors depends on individual needs, but top-rated providers for Medicare Advantage (Part C) in 2026 include Humana, UnitedHealthcare, Aetna, and Blue Cross Blue Shield (BCBS), offering nationwide coverage, large networks, $0 premium options, and extra benefits like dental/vision, while Medigap (Medicare Supplement) plans like Plan F provide comprehensive Original Medicare cost coverage. Key factors are your doctors, prescriptions, budget, and preference for network flexibility (MA) or broad coverage (Medigap).
The 80/20 Rule in health insurance, part of the Affordable Care Act, requires insurers to spend at least 80% of premium dollars on medical care and quality improvements (85% for large group plans), with the remaining 20% (or 15%) for overhead, profits, and marketing. If they don't meet these Medical Loss Ratio (MLR) standards, they must issue rebates to consumers, ensuring a minimum value from premiums.
The best people to talk to about Medicare are your local State Health Insurance Assistance Program (SHIP) (for free, unbiased advice) or your specific Medicare plan's customer service (for plan-specific questions). For enrollment, contact the Social Security Administration (SSA), while independent brokers can compare plans, and organizations like the NCOA or AARP offer resources and tools.
Starting in 2025, there is an annual limit on what you pay out-of-pocket for prescription medications through Medicare and Medicare Advantage prescription drug plans. All prescription medications, including specialty medications, covered by Part D plans are included under this cap.
Your CalPERS health coverage will automatically be canceled the first day of the month after you turn 65. Review Cancellation of CalPERS Health Coverage for information on reinstating your health coverage.