Vermont Medicare Supplement Rules: Under 65, Open Enrollment (2026)

Vermont Medicare Supplement insurers must offer people on Medicare because of a disability the same Medigap policies they sell to people on Medicare by age.1 Section 4051 of Title 8 of the Vermont Statutes Annotated (8 V.S.A. § 4051) gives those disability-eligible buyers an initial enrollment period of at least six months, and it requires insurers to set Medigap premiums by community rating rather than by an applicant's health.1 The Vermont Department of Financial Regulation (DFR) adds a second rule for policyholders who bought on disability: an insurer that rates them in a separate, more expensive pool must move them automatically into its over-65 pool once they qualify for Medicare by age.1

In This Guide

• Can You Buy Medigap in Vermont If You're Under 65?
• What Happens to Your Premium When You Turn 65?
• Does Your Health Change What You Pay for a Vermont Medicare Supplement?
• When Can You Buy at 65 With No Health Questions?
• What If Your Medicare Advantage Plan Leaves Vermont?
• Which Medicare Supplement Plans Can You Buy in Vermont?
• Should You Pick Medigap or Medicare Advantage in Vermont?
• How Are Vermont Medicare Supplement Rate Increases Reviewed?
• Which Vermont Medigap Rule Fits Your Situation?
• Who Can Help You Compare Vermont Medigap Policies?
• Frequently Asked Questions
• Learn More

Can You Buy Medigap in Vermont If You're Under 65?

Yes: Vermont law lets people under 65 buy Medigap if they have Medicare because of a disability. If you started Medicare before 65 through Social Security Disability Insurance (SSDI), Vermont gives you a Medigap purchase right that goes beyond federal law.1

Section 4051(c) of Title 8 of the Vermont Statutes Annotated, in the version effective January 1, 2026, sets these rules for any health insurer that issues Medicare Supplement policies to people eligible for Medicare by reason of age:1

• Same policies: The insurer must make available to people eligible for Medicare by reason of disability the same policies or certificates it offers and sells to people eligible by reason of age.
• At least six months to enroll: The initial enrollment period for those Medigap policies must be at least six months following the date the individual becomes eligible for Medicare by reason of disability.
• Later windows shared: Any additional enrollment periods required by law and offered to age-eligible Vermonters must also be offered to disability-eligible Vermonters.
• ESRD carve-out: Section 4051(c) does not apply to people eligible for Medicare by reason of end-stage renal disease (ESRD).

Federal law sets a lower floor. Medicare's guide Choosing a Medigap Policy, published by the Centers for Medicare & Medicaid Services (CMS), states that federal law generally doesn't require insurance companies to sell Medigap policies to people under 65. The same CMS guide lists Vermont among the states that, when the guide was printed, required insurers to offer at least one kind of Medigap policy to people with Medicare under 65.1

Buying a Medigap policy under 65 in Vermont does not use up the window at 65. Medicare's Choosing a Medigap Policy guide says a person who already has Medicare Part B still gets a Medigap Open Enrollment Period on turning 65, when that person will probably have more Medigap policy options and be able to get a lower premium.1

What Happens to Your Premium When You Turn 65?

Section 4051(a) of Vermont's Medigap statute lets an insurer set one community rate for people eligible for Medicare by age and a different community rate for people eligible by disability.1

DFR's Insurance Bulletin #208, revised January 8, 2026, explains what the split means for Vermont policyholders who bought on disability:1

• Higher cost in the disabled pool: Bulletin #208 states that Medicare Supplement plans cost more for a disabled policyholder than for one rated by age, because an insurer's disabled risk pool typically has fewer people and higher use of care.
• Automatic transfer at 65: Bulletin #208 states that when an insurer rates disability-eligible people in a separate risk pool, § 4051(a) requires the insurer to transfer those policyholders automatically to its over-65 pool once they become eligible by reason of age.
• Timing of the move: DFR's position in Bulletin #208 is that the transfer should take place on the first day of the month in which the disabled policyholder turns 65.
• Single-pool insurers: Bulletin #208 does not apply to an insurer that keeps no separate pools and charges disabled and 65-plus policyholders the same rate for each plan.

A policyholder whose premium still reflects the disabled pool after the month of their 65th birthday can call DFR's Insurance consumer line, listed in Who Can Help You Compare Vermont Medigap Policies? below.2

Does Your Health Change What You Pay for a Vermont Medicare Supplement?

Not the price. Vermont's § 4051(a) requires a health insurer to use a community rating method acceptable to the Commissioner of Financial Regulation, and it states that the premium charged shall not deviate from the community rate.1 Medicare's Choosing a Medigap Policy guide describes community-rated pricing, also called no-age-rated pricing, as generally charging everyone the same premium regardless of age or gender.1 Brevy's guide to how Medigap premiums are priced compares community rating with issue-age and attained-age pricing.

Community rating governs what a Medigap policy costs in Vermont, not whether an insurer must accept the application. DFR's guaranteed issue information sheet says that when an application is underwritten, the insurance company has discretion to accept or deny it, a practice DFR calls pass/fail underwriting.1 A Vermonter applying outside a protected window can therefore be turned down, even though a policy that is issued carries the community rate.1

DFR's information sheet also says Vermonters may apply for Medicare Supplement plans throughout the year, depending on their eligibility.2 Applying is not the same as guaranteed acceptance; the protected windows are the age-65 period under Section 11 and the guaranteed issue periods under Section 12, both described below.

When Can You Buy at 65 With No Health Questions?

Vermont's Medicare Supplement Insurance Minimum Standards Rule, DFR Regulation H-2009-04 (Revised), sets the age-65 window in Section 11. For an application submitted before or during the six months beginning with the first day of the first month a person is both 65 or older and enrolled in Medicare Part B, a Medigap issuer may not:1

• deny or condition the issuance or effectiveness of any Medicare Supplement policy available for sale in Vermont;
• discriminate in pricing because of the applicant's health status, claims experience, receipt of health care, or medical condition.

Section 11 also requires each Medicare Supplement policy an insurer currently has available to be made available to every applicant who qualifies for the age-65 window, without regard to age.1 The Section 11 window depends on being 65 or older and in Part B, so it is not an under-65 right; the under-65 right comes from § 4051(c).1

Federal law matches the timing. Section 1882 of the Social Security Act bars a Medigap issuer from denying, conditioning or pricing a policy on health for an application submitted before or during the six months beginning with the first month a person is 65 or older and enrolled in Part B.3 Medicare.gov calls the federal Medigap Open Enrollment Period a one-time enrollment period that doesn't repeat every year.3 Brevy's national guide to the Medigap open enrollment period covers the federal mechanics.

Will pre-existing conditions be covered right away?

A guaranteed sale in the age-65 window does not always mean immediate coverage for every condition. Regulation H-2009-04, Section 11, sets three rules for pre-existing conditions:1

• Six months of creditable coverage or more: An issuer may not exclude benefits based on a pre-existing condition for an applicant who, on the date of application, has had at least six months of continuous creditable coverage.
• Less than six months: The issuer must shorten any pre-existing condition exclusion by the total time of the applicant's creditable coverage.
• Otherwise: Section 11 does not prevent a Medigap policy from excluding benefits during its first six months for a condition that was treated or diagnosed in the six months before coverage took effect.

Regulation H-2009-04 counts coverage as continuous only if no break in creditable coverage lasted more than 63 days.1 A Vermonter moving to Medicare from job-based or other coverage should keep the dates of that coverage, because a break of more than 63 days means the earlier coverage no longer counts as continuous under the regulation. Brevy's guide to Medigap and pre-existing conditions explains the look-back.

Outside the window, Medicare's Choosing a Medigap Policy guide says there's no guarantee an insurance company will sell a Medigap policy to a person who doesn't meet its medical underwriting requirements, unless that person has a guaranteed issue right.1

What If Your Medicare Advantage Plan Leaves Vermont?

Medicare Advantage has shrunk in Vermont. DFR's Medicare Supplement 101 page says that, as of October 1, 2025, few Medicare Advantage plans are offered for sale in Vermont.2 DFR's guaranteed issue information sheet says many health insurers have left Vermont's Medicare Advantage marketplace since 2023, and that Vermonters are re-examining the Medicare Supplement marketplace as a result.2

Section 12 of DFR Regulation H-2009-04 creates Vermont's Medigap guaranteed issue rights. For an eligible person who applies during the guaranteed issue period and submits evidence of the date of termination, disenrollment, or Medicare Part D enrollment with the application, an issuer may not deny or condition a Medicare Supplement policy described in the regulation that it offers to new enrollees, may not price it on health, and may not impose a pre-existing condition exclusion.1

Eligible persons under Section 12 of Regulation H-2009-04 include:1

1. People whose employer plan that supplements Medicare ends, or stops providing some or all of those supplemental benefits.
2. People in a Medicare Advantage plan whose certification is terminated, whose organization discontinues the plan in the area where they live, or who are no longer eligible because they moved.
3. People whose Medicare Supplement coverage ends because the issuer became insolvent or because of another involuntary termination.
4. People who dropped a Medicare Supplement policy to join a Medicare Advantage plan for the first time, or who joined Medicare Advantage when first enrolling in Part B, and who leave within the first twelve months, have a guaranteed issue right under Vermont Regulation H-2009-04, Section 12.

The Section 12 clocks are short. Under Section 12, a guaranteed issue period after an employer plan ends begins on the later of the notice of termination or the date coverage ends, and closes 63 days after that date.1 For a person whose Medicare Advantage enrollment is ended involuntarily, the Section 12 period begins on the date of the notice of termination and ends 63 days after coverage terminates.1

A Section 12 guaranteed issue right does not reach every Medigap plan. DFR's information sheet says not all Medicare Supplement plans are on the guaranteed issue list, that the list depends on individual circumstances such as the date a person first became eligible for Medicare, and that plans an insurer is not required to offer on a guaranteed issue basis may still be available with health questions and may be denied.1 Brevy's national guide to Medigap guaranteed issue rights explains which policies the federal situations reach, and Medicare's Choosing a Medigap Policy guide notes that you may have additional rights under state law.1

Which Medicare Supplement Plans Can You Buy in Vermont?

Medigap plans are standardized by letter. Medicare's Choosing a Medigap Policy guide charts Plans A, B, C, D, F, G, K, L, M and N, and states that all insurance companies that sell Medigap policies must offer at least Plan A.1 Section 4051(c) of Vermont's statute means a disability-eligible Vermonter can buy any of the policies an insurer sells to age-eligible buyers, not a shorter list.1

The federal 2020 change to Plans C and F also shapes what Vermonters can buy. Medicare's guide states that Medigap plans sold to people new to Medicare on or after January 1, 2020 aren't allowed to cover the Part B deductible, so Plans C and F aren't available to those people, who have the right to buy Plans D and G instead.1 Medicare's guide also says a person eligible for Medicare before January 1, 2020 who hasn't yet enrolled may be able to buy Plan C or Plan F, and that Medigap Plans E, H, I and J are no longer sold, though a person who already has one can generally keep it.1

Brevy's guides to how the lettered Medigap plans work and to Plan G versus Plan N compare the letters benefit by benefit.

Should You Pick Medigap or Medicare Advantage in Vermont?

DFR's Medicare Supplement 101 page describes Medicare Supplement policies as coverage sold by private insurance companies that pays some, but not all, of the gaps in Original Medicare Part A and Part B, and says Medigap is accepted by any provider or facility that accepts Medicare, without network restrictions.2 The same DFR page warns that rules restrict your ability to change between Medicare Advantage and Medicare Supplement plans.2

The CMS booklet Understanding Medicare Advantage Plans sets out the federal rules behind that warning:4

• A Medigap policy can't be used to pay Medicare Advantage Plan copayments, coinsurance, deductibles or premiums.
• For someone in a Medicare Advantage Plan, the CMS booklet says it's illegal for anyone to sell a Medigap policy unless the person is switching back to Original Medicare.
• In most cases, a person who drops a Medigap policy to join a Medicare Advantage Plan may not be able to get the same policy back.
• A person who joins a Medicare Advantage Plan for the first time and isn't happy with it has a federal "trial right" to buy a Medigap policy and a separate Medicare drug plan when returning to Original Medicare within 12 months of joining.

Brevy's guides to Medicare Advantage trial rights and to Original Medicare versus Medicare Advantage walk through the choice in more detail.

Changing Medigap policies later is limited as well. Medicare.gov's page on how to switch or drop a Medigap policy says its answers cover only federal rights, and that in most cases you won't be able to switch Medigap policies outside your six-month Medigap Open Enrollment Period unless you have a guaranteed issue right.5 When a Medigap switch does go through, Social Security Act §1882(s)(2)(C) bars the replacing policy from imposing a new pre-existing condition, waiting, elimination or probationary period for similar benefits if the old policy had been in effect for six months or longer.5 Medicare.gov adds that a person who drops a Medigap policy might not be able to get it or any policy back later.5

How Are Vermont Medicare Supplement Rate Increases Reviewed?

Vermont posts every Medigap rate increase request publicly. Under 8 V.S.A. § 4051(b), within five business days after receiving a request to raise a Medicare Supplement premium rate, DFR must post on its website:6

• the name of the health insurer;
• the overall composite average rate increase requested;
• the increase requested by plan type;
• the date the proposed increase would take effect;
• the System for Electronic Rate and Form Filing (SERFF) tracking number and a web address for the filing;
• instructions and a deadline for submitting public comments.

Larger requests from larger insurers can go to a public hearing. For a filing by a health insurer with 5,000 or more total lives in Vermont's Medicare Supplement market that seeks a composite average increase above 10 percent, § 4051(b) requires the Commissioner to solicit public comment and to hold a public hearing if one is requested within 30 days after the filing information is posted.6 Under § 4051(b), a hearing request can come from the Department of Disabilities, Aging and Independent Living (DAIL), from the Office of the Health Care Advocate, or from at least 25 policyholders whose premium rates would be affected.6

Timing is fixed by § 4051(d): an insurer must file its premium rate request for a policy with a January 1 effective date no later than July 1 of the year before.6 DFR's Medicare Supplement 101 page posts a table of Medicare Supplement rates under review and links to approved rates.6

Which Vermont Medigap Rule Fits Your Situation?

The table above condenses 8 V.S.A. § 4051, DFR Regulation H-2009-04 and Bulletin #208; the sections above carry the exact wording and limits.1,6

Who Can Help You Compare Vermont Medigap Policies?

• DFR Insurance consumer line: DFR's Medicare Supplement 101 page lists the Department of Financial Regulation's Insurance consumer contact at 802-828-3302 and toll-free at 833-337-4685.2
• Vermont SHIP counseling: DFR's Medicare Supplement 101 page refers Vermonters to counseling from the Vermont State Health Insurance Assistance Program (SHIP) at 1-800-642-5119.2
• 1-800-MEDICARE: For Original Medicare questions, 1-800-MEDICARE (1-800-633-4227) is the official line run by CMS, and TTY users call 1-877-486-2048; Medicare.gov says callers can reach a real person 24 hours a day, 7 days a week, except some federal holidays.7

Brevy's Vermont Medicare hub covers the rest of Medicare in the state.

Learn More

Find personalized help using Vermont's under-65 Medigap right and timing your guaranteed issue window 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.