What G.S. 58-54-45 requires
Federal law doesn't make companies sell Medigap to people under 65, so the answer depends on the state. North Carolina's statute, titled "By reason of disability," says a Medigap company "shall at least make standardized Medicare Supplement Plan A available to persons eligible for Medicare by reason of disability before age 65." For people first eligible for Medicare on or after January 1, 2020, it must also offer Plan D or Plan G if it markets either to people 65 and older. (For people eligible before 2020, the law names Plan C or Plan F instead.)
- No health screening: the offer is made "without regard to medical condition, claims experience, or health status."
- Your window: the 6 months beginning with the first month you enroll in Part B. If Social Security grants Part B retroactively, the 6 months start the month you are notified.
- Price: companies may set separate rates for people under 65 with a disability. Rates must be filed with and approved by the Commissioner of Insurance.
If your Medicare Advantage plan ends
The same statute gives people under 65 with a disability a second protection. If your managed care plan, such as a Medicare Advantage plan, is canceled or not renewed, or you leave it, you have a guaranteed right to buy Plan A, D or G from any company within 63 days (G.S. 58-54-45(b)). Some Medicare Advantage plans are ending in North Carolina for 2027; see plans ending in 2027.
How to use your window
- Mark the date your Part B starts. Your 6 months count from that month, not from when you hear about Medigap.
- Ask each company which plans it offers people under 65. Plan A is required; D or G only if the company sells them at 65 and older.
- Compare Medigap with Medicare Advantage. If your income is limited, you may also qualify for NC Medicaid or a Medicare Savings Program, which changes what coverage makes sense. See Medicare Savings Programs in North Carolina.
- Plan for 65. Your new open enrollment lets you switch to any plan letter a company sells, with no health questions.
To compare Medigap policies from the companies they work with, you can request a call from a licensed insurance agent. More in Medigap in North Carolina and getting Medicare before 65.
Related questions
When can I buy Medigap in North Carolina?
Every window, in one table.
Can I get Medigap with pre-existing conditions?
Waiting periods and protections.
Are Medigap rates based on age in North Carolina?
How companies set prices.
Sources
- N.C. General Assembly — G.S. 58-54-45, By reason of disability
- Medicare.gov — Get ready to buy (Medicare because of a disability or ESRD)
- Medicare.gov — When can I buy a Medigap policy?
More questions in this guide
- Are Medigap rates based on age in North Carolina?
- Can I get a Medicare Supplement with pre-existing conditions in North Carolina?
- Can I switch Medigap plans in North Carolina?
- Does North Carolina have a Medigap birthday rule?
- Medigap Plan G vs. Plan N in North Carolina
- What happens to my Medigap if I move out of North Carolina?
- When can I buy a Medicare Supplement plan in North Carolina?
Part of the guide: Medigap (Medicare Supplement) in North Carolina · All questions
Frequently asked questions
Can a company charge me more because I'm under 65?
It can. G.S. 58-54-45(c) lets companies set premium rates specific to people under 65 with a disability, but they can't price by your health in this window, and the rates must be filed with and approved by the Commissioner of Insurance.
Does the North Carolina rule cover people with ESRD?
The statute covers people eligible for Medicare 'by reason of disability' and doesn't mention end-stage renal disease separately. If you have Medicare only because of ESRD, ask the company or the North Carolina Department of Insurance whether the rule applies to you.
What if I missed my under-65 window?
Companies can then use medical underwriting until you turn 65, unless you have a guaranteed-issue right, such as your Medicare Advantage plan ending.
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