Medicare under 65
Medicare before 65, and the Colorado rule nobody mentions
Figures on this page checked . Medicare and marketplace numbers reset every year — if you are reading this long after that date, call and we will tell you what moved.
Colorado carriers have to sell to you
Federal law guarantees a Medigap window at 65. It says nothing about people who qualified for Medicare through disability before then, which is why in many states a 52-year-old on Medicare cannot buy a Medicare Supplement policy at any price.
Colorado is not one of those states
State regulation requires carriers to make every policy the carrier currently sells in Colorado available to applicants under 65, without asking health questions, during a 6-month window. They must also actively market to you, and they are forbidden from steering you toward another company because of your health.
That last part is in the rule because it used to happen. A carrier that would rather not cover you cannot solve the problem by suggesting you try somebody else.
When your window opens, and it is not your birthday
The 6 months start the first day of the first month you are enrolled in Medicare Part B, without regard to age. For most people who qualified through disability, that is the month Medicare began — typically after twenty-four months of Social Security disability benefits.
So the window may already have opened and closed without anyone telling you it existed. That is the common story here. Knowing where you stand still matters even if the answer is that you missed it, because of what happens at 65.
In plain terms
“Guaranteed issue” means the carrier must sell you the policy at their standard rate for your category and cannot ask about your health, your claims, or your diagnosis. It does not mean the price is the same as somebody else’s. Those are two different questions and the second one is below.
What it costs, stated plainly
Colorado requires carriers to sell to you. It does not require them to sell at the same price, and they generally do not.
The regulation caps how far apart the prices can be. A carrier introducing a new product may charge under-65 applicants 1.5 times the age-65 rate; other filings have to stay within the highest rate they already charge for that plan, or apply the same adjustment they apply to everyone over 65.
In practice a Medigap policy can be expensive before 65, and for some people a Medicare Advantage plan or a Medicare Savings Program is the better answer for now. We will tell you when that is the case. A right you cannot afford to use is not advice.
The second window, at 65
Here is the part to put in your calendar. When you turn 65, you get a full guaranteed-issue window again — the same six months everyone aging into Medicare gets, on the same terms, priced as a 65-year-old rather than as an under-65 applicant.
The Colorado Division of Insurance says outright that people in this situation should review the available policies then and see whether they can get a better price. That is the state regulator telling you to shop, which is not something regulators say often.
What this means if you missed the first window
It is not permanent. Whatever happened when your Medicare started, 65 gives you a clean opening with no health questions. If you are 63 or 64 and reading this, that is the date to plan around.
The rest of your options
Medigap is one road, and for a lot of people under 65 it is not the affordable one. The rest of the map:
- Medicare Advantage is open to you on the same terms as anyone else. Advantage plans cannot ask health questions from anybody, at any age, and they cap what you pay in a year.
- Medicare Savings Programs can pay your Part B premium and sometimes more, depending on your income and resources. Applying costs nothing and people who qualify often assume they do not.
- Extra Help for prescriptions lowers Part D costs substantially and is a separate application from the one above.
- Health First Colorado alongside Medicare, if your income qualifies. That combination has its own set of plans.
If you have both Medicare and Medicaid, the options change again and mostly in your favor.
If you have ESRD or ALS, the rules differ
Two conditions have their own Medicare paths. People diagnosed with ALS are exempt from the twenty-four-month wait and get Medicare when their disability benefits begin. People with end-stage renal disease qualify on a separate schedule tied to dialysis or a transplant.
The Medigap picture for end-stage renal disease is different enough that we will not summarize it here and get it half right. Call us, or call the State Health Insurance Assistance Program, which counsels for free and has no product to sell you.
Questions about Medicare before 65
Can I buy a Medicare Supplement policy under 65 in Colorado?
Yes. Colorado regulation requires every Medigap carrier selling here to make all of their currently available policies open to applicants under 65 who have Medicare, during a six-month window that starts when your Part B coverage starts.
This is a state rule, not a federal one, and most states do not have it. If you have read elsewhere that people under 65 cannot get Medigap, that was almost certainly written for a different state or written generically about federal law.
My Medicare started years ago. Did I miss my chance?
For the under-65 window, probably yes — it runs six months from when Part B started. Outside it, a Colorado carrier can medically underwrite you and can decline.
You have not missed everything, though. At 65 you get a fresh six-month guaranteed-issue window on standard terms, and the Colorado Division of Insurance specifically advises people in your position to shop then. Medicare Advantage is also available to you at any point without health questions.
Why is the premium so much higher than what my neighbor pays?
Because Colorado requires carriers to sell to you but allows them to price under-65 policies higher. For a newly introduced product the regulation permits up to 1.5 times the age-65 rate, and other filings are held to the highest rate the carrier already charges for that plan.
Compare several carriers rather than assuming the spread is fixed — the rules leave room for real differences between companies. Then run the same numbers against a Medicare Advantage plan, which is a comparison we will do with you either way.
I am under 65, on Medicare, and still working. What applies to me?
If you have coverage through a current employer with 100 or more employees, the group plan generally pays first and you may be able to delay Part B without a penalty. Note the threshold: it is 100 employees when you qualified through disability, not the 20 that applies at 65.
That difference catches people who read the general Medicare guidance and apply it to themselves. Tell us your employer size and how you qualified for Medicare before deciding anything about Part B.
CMS-required disclaimer
We do not offer every plan available in your area. Currently we represent 7 organizations which offer 45 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all of your options.