Am I eligible for a Medigap disablility insurance policy if I'm on Social Security disability?

1 answer | Last updated: Aug 20, 2010
Debbie 207 asked...

I am 58 and on Social Security Disability. Am I eligible for a Medigap disablility insurance policy?

Expert Answers

It depends on where you live. You are eligible for all parts of Medicare when you've been receiving Social Security Disability Insurance (SSDI) benefits for 24 months. But eligibility for private Medigap supplemental insurance policies is guaranteed by the federal government only if you are enrolled in Medicare and are age 65 or older. However, many states require insurance companies to offer Medigap policies to people under 65 who are enrolled in Medicare on the basis of their SSDI qualification. (In other states, insurance companies may sell you a Medigap policy, but they are not required to.) The states that require insurance companies to offer at least one type of Medigap policy to people with SSDI-qualified Medicare are:

California           Louisiana     Missouri    Pennsylvania    Colorado       Maine                   New Hampshire                      South Dakota
Connecticut      Maryland        New Jersey        Texas                 Hawaii           Massachusetts  New York          Vermont         Illinois          Michigan           North Carolina   Wisconsin
Kansas             Minnesota      Oklahoma
Kentucky           Mississippi    Oregon

Be aware, however, that these laws do not require a Medigap insurance company to sell you any Medigap policy they offer to people age 65 or older. They are only required to sell you at least one type of Medigap policy, which may not be the one you would prefer. Some companies may offer more than one type, but if so they will likely charge you more than they would someone age 65 who is automatically eligible for all policies. And if you have a medical condition that does or might require considerable care or treatment, an insurance company has a right to deny you any of these extra policies.

If you don't live in a state where you can get a Medigap policy, or if the policies you could get are unsatisfactory or too expensive, you might consider joining a Medicare Part C Medicare Advantage plan. These plans provide all the coverage of original Medicare Part A and Part B, plus the same kinds of extra coverage that Medigap insurance provides (and often more than Medigap policies offer). These plans usually have restrictions on the health care providers you can use, but they may provide you with better coverage than a limited Medigap policy, and certainly better than no Medigap policy at all.