Pennsylvania Medicare Supplement (Medigap) open enrollment lasts 6 months, starts the first month you're enrolled in Medicare Part B, and applies at any age, including under 65. During the 6-month Pennsylvania Medigap open enrollment period, a Pennsylvania Medigap insurer can't refuse your application or price it on your health, and under 31 Pa. Code § 89.778 every policy it sells must be made available "without regard to age." Federal law, by contrast, generally doesn't require any Medigap sale to people under 65.,

In This Guide

How Pennsylvania Medicare Supplement Open Enrollment Works

The Pennsylvania Insurance Department (PID) states that Pennsylvania Medigap open enrollment starts on the first day of the month in which you first enrolled in Medicare Part B and lasts for six months.

Under 31 Pa. Code § 89.778, the Pennsylvania window runs for 6 months from the first day of the first month in which either of these happens:

  • You enroll in Part B. For most people, this is the start date.
  • You get a retroactive Part B notice. If a Social Security Administration decision enrolls you in Part B retroactively, the window starts in the month you received notice of retroactive eligibility to enroll.

You can also apply before the window opens. Section 89.778 covers an application submitted "prior to or during" the 6-month period.

What a Pennsylvania Medigap insurer can't do during open enrollment

For an application submitted in the Pennsylvania open enrollment window, § 89.778 bars a Medigap insurer from doing three things because of your health status, claims experience, receipt of health care, or medical condition:

  1. Denying the policy.
  2. Conditioning the issuance or effectiveness of the policy.
  3. Discriminating in the policy's price.

The rule reaches every Medigap policy or certificate the insurer has available for sale in Pennsylvania.

The preexisting-condition rule

Pennsylvania's open enrollment rule also limits waiting periods for preexisting conditions, and the answer turns on your prior creditable coverage as of the date you apply:

  • At least 6 months of continuous creditable coverage: the Pennsylvania Medigap insurer may not exclude benefits based on a preexisting condition.
  • Less than 6 months: the insurer must shorten any preexisting-condition exclusion period by the amount of creditable coverage you had.

The group-policy caveat

Section 89.778 has one limit on the "any age" rule. For group Medigap policies, a Pennsylvania insurer may condition issuance on whether you are a member of the insured group or eligible to join it.

Under 65 With a Disability or ESRD

Pennsylvania Medigap insurers must sell to people under 65 during open enrollment. The Pennsylvania Insurance Department's Medigap guide answers the question of whether someone under 65 with a disability or end-stage renal disease (ESRD) can buy a Medigap policy this way: "Yes. In Pennsylvania, Medigap insurance companies are required to sell you a Medigap policy if you are in your open enrollment period."

The regulation goes further than one plan. Under 31 Pa. Code § 89.778, each Medigap policy and certificate a Pennsylvania insurer currently makes available must be made available to qualifying applicants "without regard to age." Medicare's federal guide, Choosing a Medigap Policy, lists Pennsylvania among the states that, at the time of printing, require insurance companies to offer at least one kind of Medigap policy to people with Medicare under 65.

The Pennsylvania under-65 right is tied to the open enrollment window, not open-ended. A hypothetical 58-year-old in Scranton who is newly enrolled in Part B after qualifying for Social Security Disability Insurance (SSDI) has 6 months, starting with his first month of Part B, in which a Pennsylvania Medigap insurer can't refuse him a policy or charge him more because of his health. After that window closes, the Pennsylvania Insurance Department's warning under After Your Window applies to him, and before counting on one of the guaranteed issue situations described there, he should confirm with PID or PA MEDI that it applies to him.,

What happens at 65

Federal law defines the Medigap Open Enrollment Period as the 6 months starting with the first month you have Part B and are 65 or older. If you first bought a Pennsylvania Medigap policy under 65, confirm with PID or PA MEDI, Pennsylvania's free State Health Insurance Assistance Program (SHIP) counseling service (see Where to Get Free Help), whether a new window applies to you at 65 before you count on one.

Federal Baseline vs. the Pennsylvania Rule

Pennsylvania's Medigap open enrollment rule departs from federal law on two points: when the window starts and whether it covers people under 65.,,

Question Federal baseline Pennsylvania rule
When does the 6-month open enrollment start? The first month you have Part B and are 65 or older The first month you're enrolled in Part B (or the month you get a retroactive Part B notice)
Must insurers sell to people under 65? Federal law generally doesn't require it Yes, during open enrollment: every policy an insurer sells is available without regard to age
Does the window repeat? No: the Medigap Open Enrollment Period is one-time and doesn't repeat every year After it closes, see After Your Window for PID's warning and the guaranteed issue situations

After Your Window: Pennsylvania Guaranteed Issue Rights

Missing the Pennsylvania open enrollment window has consequences. PID warns that if you don't buy a Medigap policy during your Medigap Open Enrollment Period, "you may have to pay more for a policy, have fewer policy options available to you, and there's no guarantee an insurance company will sell you a Medigap policy."

Specific events reopen the door. Under 31 Pa. Code § 89.790, an eligible person applying within the guaranteed issue period is protected: a Pennsylvania Medigap insurer may not deny or condition an eligible policy it offers to new enrollees, may not price it higher because of health status or medical condition, and may not impose a preexisting-condition exclusion.

Your situation When to apply What you can buy
Your Medicare Advantage plan leaves Medicare, stops giving care in your area, or you move out of its service area (only if you switch to Original Medicare rather than join another Medicare Advantage plan) § 89.790 window (see below) Generally Plan A, B, C, D, F, G, K or L sold in Pennsylvania by any insurer (see note below)
Employer group health plan (including retiree or COBRA coverage) or union coverage that pays after Medicare is ending No later than 63 calendar days after the latest of: the date coverage ends, the date on the notice that it's ending, or the date on a claim denial if that's how you learn it ended Generally Plan A, B, C, D, F, G, K or L sold in Pennsylvania by any insurer (see note below)
You have Original Medicare and a Medicare SELECT policy and move out of its service area Confirm the deadline with PID Confirm with PID which plans you can buy
Trial right #1: you joined Medicare Advantage or a Program of All-Inclusive Care for the Elderly (PACE, not Pennsylvania's PACE prescription-assistance program) when first eligible for Part A at 65 and want to switch to Original Medicare within the first year § 89.790 window (see below) Any Medigap policy an insurer offers
Trial right #2: you dropped a Medigap policy to join Medicare Advantage (or switch to Medicare SELECT) for the first time, have been in the plan less than a year, and want to switch back § 89.790 window (see below) Confirm with PID which plans you can buy
Your Medigap insurer goes bankrupt, or your Medigap coverage otherwise ends through no fault of your own For insurer bankruptcy, no later than 63 calendar days from the date your coverage ends Generally Plan A, B, C, D, F, G, K or L sold in Pennsylvania by any insurer (see note below)

Plan letters in the right-hand column come from PID's guide, which lists them for most guaranteed issue situations (for the Medicare SELECT and trial right #2 rows, confirm the available plans with PID); Plans C and F apply only to people newly eligible for Medicare before January 1, 2020, and Plans D and G to people newly eligible on or after that date. Under § 89.790, a person in the first-eligibility trial right situation (trial right #1) may buy any Medigap policy an insurer offers.

The § 89.790 application windows

For the Medicare Advantage and trial-right situations, 31 Pa. Code § 89.790 sets the Pennsylvania guaranteed issue period two ways:

  • If your enrollment is ended involuntarily: the period begins when you receive a notice of termination and ends 63 days after the coverage ends.
  • If you leave voluntarily: the period begins 60 days before the effective date of your disenrollment and ends 63 days after it.

Two more details from PID's guide and § 89.790. If you have COBRA, you can buy a Pennsylvania Medigap policy right away or wait until the COBRA coverage ends. And § 89.790 also treats as guaranteed issue events a Medicare Advantage organization or Medigap insurer substantially violating a material provision of its contract or policy, or materially misrepresenting the plan's or policy's provisions in marketing it to you.

A hypothetical 67-year-old in Pittsburgh whose Medicare Advantage plan is leaving her county fits the first row: if she returns to Original Medicare rather than joining another Medicare Advantage plan and applies within the § 89.790 window, a Pennsylvania Medigap insurer must sell her a Medigap policy from PID's plan list without health-based pricing or preexisting-condition exclusions.

Which Medicare Supplement Plans Are Sold in Pennsylvania

PID states that Pennsylvania Medicare Supplement plan types are identified by letter, and that A, B, C, D, F, G, K, L, M and N are the most common.

  • Same letter, same benefits. Companies may charge different amounts for a policy, but PID states the benefits are identical: every Plan A offers the same benefits regardless of which company sells it.
  • Plan A is always available from a Medigap seller. Medicare's federal guide states that all insurance companies that sell Medigap policies must offer at least Plan A. Not all companies sell all the other plans.
  • Plans C and F (and high-deductible F): PID states these can be purchased only by people who were eligible for Medicare before January 1, 2020. Medicare's guide says you're considered new to Medicare if you turned 65 on or after January 1, 2020, and got Part A on or after that date.
  • Plans E, H, I and J: no longer sold, but if you already have one, PID says you may keep it.

Three other Pennsylvania ground rules from PID: you must have Medicare Parts A and B to buy a Medigap policy, you and your spouse must buy separate policies, and Medigap policies sold after January 1, 2006, do not include prescription drug coverage. For how each lettered plan's benefits compare, see Brevy's guide to how the lettered Medigap plans work.

How Pennsylvania Medigap Premiums Are Set

PID's Medigap guide states that each insurance company sets its own prices for Medigap policies, subject to Pennsylvania Insurance Department approval.

PID describes three ways a Pennsylvania Medigap premium can be set:

  • Community-rated: the premium is not based on your age; the same premium is charged to everyone.
  • Issue-age-rated (entry-age-rated): the premium is based on your age when you buy the policy.
  • Attained-age-rated: the premium is based on your current age and goes up as you get older.

In all three cases, PID says premiums may increase each year due to inflation and other factors, and insurance companies may charge different premiums for the same Medigap policy. When two Pennsylvania insurers sell the same plan letter, the benefits are identical; the premium and the way it's rated can differ. Brevy's guide to how Medigap premiums are priced covers the three methods in more depth.

Medigap and Medicare Advantage in Pennsylvania

Medigap works only with Original Medicare. Medicare's booklet "Understanding Medicare Advantage Plans" says you can't use Medigap to pay your Medicare Advantage plan's copayments, coinsurance, deductibles, and premiums.

The booklet also states that if you're in a Medicare Advantage plan, "it's illegal for anyone to sell you a Medigap policy unless you're switching back to Original Medicare," and that you should report anyone who tries to your State Insurance Department, which in Pennsylvania is PID.

Dropping Medigap to join Medicare Advantage carries a risk: Medicare's booklet says that in most cases you may not be able to get the same policy back. Federal law gives a trial right if you join a Medicare Advantage plan for the first time and aren't happy with it: you can buy a Medigap policy and a separate Medicare drug plan if you return to Original Medicare within 12 months of joining. In Pennsylvania, the two trial rights and their application windows are in the guaranteed-issue table above, and Brevy's guide to switching between Medicare Advantage and Original Medicare walks through the federal side.

The fall Medicare Open Enrollment Period, October 15 through December 7, is when you can switch from Medicare Advantage to Original Medicare, with the change taking effect January 1. Leaving Medicare Advantage is one decision and buying Medigap is another: before you leave, check whether one of the Pennsylvania guaranteed issue situations in the table above applies to you, because PID's warning about buying outside your open enrollment window (see After Your Window) applies otherwise.

Your Protections After You Buy

PID's Medigap guide lists these Pennsylvania consumer protections:

  • 30-day free look: you have 30 days from the date you received a Pennsylvania Medigap policy to review it, and if you return it within that time, the insurance company must refund in full the premium you paid.
  • Guaranteed renewable: standardized Medigap policies can't be canceled by the insurance company as long as you pay the premium.
  • Canceling is your call, in writing: you cancel a Pennsylvania Medigap policy by writing to your insurance company directly; your insurance agent may not cancel it for you.
  • Complaints: if you believe the law has been broken, PID asks you to call the Pennsylvania Insurance Department at 1-877-881-6388.

Federal law adds a protection for switching. Under Section 1882 of the Social Security Act, if a Medigap policy replaces another Medigap policy that has been in effect for 6 months or longer, the new policy may not impose a new waiting period for preexisting conditions for similar benefits.

Where to Get Free Help in Pennsylvania

For the rest of your Medicare choices in the state, see Brevy's guide to Medicare plans and coverage in Pennsylvania.

Frequently Asked Questions

Can I buy Medigap in Pennsylvania if I'm under 65?

Yes, during your open enrollment window. Under 31 Pa. Code § 89.778, a Pennsylvania resident under 65 with Medicare can buy any Medigap policy an insurer sells, without health-based denial or pricing, if the application is submitted before or during the 6 months starting with the first month of Part B enrollment.

Can I apply for Pennsylvania Medigap before my Part B starts?

Yes. Under 31 Pa. Code § 89.778, Pennsylvania's open enrollment protections cover a Medigap application submitted "prior to or during" the 6-month period that begins with the first month you're enrolled in Medicare Part B, so you can apply early without losing them.

Can I switch Medigap plans later without health questions?

Only in specific situations. Medicare.gov says that in most cases you can't switch Medigap policies outside your open enrollment period unless you have a guaranteed issue right, and that otherwise you may pay more and have to answer medical questions. Pennsylvania's guaranteed issue situations under 31 Pa. Code § 89.790, such as a Medicare Advantage plan leaving your area or employer coverage ending, are listed in the table above.

Can I get Plan F or Plan C in Pennsylvania?

Only if you were eligible for Medicare before January 1, 2020: PID states Pennsylvania Medigap Plans C, F and high-deductible F can be purchased only by people who were eligible for Medicare before that date.

What if I change my mind after buying a Pennsylvania Medigap policy?

Pennsylvania gives you a 30-day free look: return the Medigap policy within 30 days of receiving it and the insurer must refund the full premium you paid.

Learn More

MedicareMedicare Plans and Coverage in PennsylvaniaMedicare in Pennsylvania for 2026: Part A, Part B, Medicare Advantage, Part D and Medigap, plus PACE/PACENET and programs that help pay your costs. MedicareWhen Is the Medigap Open Enrollment Period? The One Window That MattersYour Medigap Open Enrollment Period is a one-time, 6-month window that starts when you're 65 and on Part B. Buy inside it or you may be turned down later. MedicareMedigap Guaranteed Issue Rights: When an Insurer Must Sell You a PolicyMedigap guaranteed issue rights are federal situations where an insurer must sell you a policy, no health questions. See the triggers and the 63-day deadline. MedicareNew Jersey Medicare Supplement (Medigap) and the Under-65 RulesNew Jersey guarantees Medigap Plan D to under-65 Medicare beneficiaries with no age surcharge. The 2026 rules, the 12-month deadline, and how to apply. MedicareRhode Island Medicare Supplement (Medigap): Your Right to Switch Every FallRhode Island Medicare Supplement (Medigap) guide: the yearly fall guaranteed-issue right, who qualifies, the 90-day gap rule, and Plan A for people under 65. MedicarePennsylvania PACE and PACENET: How the State Helps Pay Your Medicare Drug CostsPennsylvania's PACE and PACENET help residents 65 and older pay Medicare Part D drug costs. See the 2026 income limits, no asset test, and how to apply.

Find personalized help comparing Medicare Supplement plans in Pennsylvania at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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