Medicare Supplement

Medigap for People Under 65 With a Disability: Federal Silence and State Rules

Federal law does not make companies sell Medigap to people under 65. Some states add their own rules. See what to check with your state, and the new window you get at 65.

Updated November 8, 2026 · 8-minute read

Key takeaways

Medigap is a policy that pays toward the costs Original Medicare leaves behind. It does not cover a service on its own.
If you are under 65 and have Medicare through a disability or end-stage renal disease, you might not be able to buy a Medigap policy until you turn 65.
Federal law in most cases does not require companies to sell Medigap policies to people under 65.
In some states, companies do offer Medigap policies to people under 65. Those offers rest on state law.
Your State Insurance Department is the source for your rights under state law. Call it before you shop.
At 65, a fresh Medigap open enrollment window opens. Our guide on the six-month window at 65 shows how it works.
You still pay for Medicare itself: the Part B premium is $202.90 per month in 2026 (Ledger A1), and the Part B deductible is $283 for the year (Ledger A2). No Medigap premium figure is stated in this guide, since companies set those prices.

You have Medicare before 65. You got it through a disability or through end-stage renal disease. You shop for a Medigap policy to help with costs. Then you hit a wall. Shops say no, or say they do not sell to people your age. This is not a clerical error. Federal law is silent here, and that silence is the whole story. This guide shows what federal law does and does not say, where state rules step in, and what window opens when you turn 65. Our Medicare Supplement section holds more guides on these policies.

Why this gap exists

Medigap rules were built for people who join Medicare at 65. The strong shields in those rules tie to age 65 and to the start of Part B at that age.

People who join Medicare young come in by a distinct door. They qualify through a disability or through end-stage renal disease. The federal Medigap shields do not reach that door in the same way.

The gap is a gap in the law, not a flaw in your papers. Your Medicare is real and full. It is the right to buy a Medigap policy that federal law does not grant at your age.

What federal law says, and what it does not

Medicare.gov puts the core fact in plain terms. If you are under 65 and have Medicare because of a disability or end-stage renal disease, you might not be able to buy a Medigap policy until you turn 65.

The reason sits one line down. Federal law in most cases does not require insurance companies to sell Medigap policies to people under 65.

That is all federal law says on the point. It does not ban sales to people under 65. It does not set a price for such a sale. It does not give you a federal window with no health checks at this age. It is silent, and in that silence the choice falls to states and to companies.

Contrast that with the rules at 65. Outside a protected window, a company may charge more, offer fewer policy choices, or deny a policy if you do not meet its health checks. Inside the window at 65, those health checks fall away. At your age, there is no federal window of that kind.

Where state rules step in

Some states have filled the gap with their own laws. In some states, insurance companies do offer Medigap policies to people under 65.

State rules vary a lot. One state may require a sale with no health checks for a set span. A state may allow sales but let companies set terms. A state may have no rule at all, which leaves the choice to each company.

This guide lists no state by name for that reason. A list built from a partial check would mislead more than it helps. Your rights rest on the law of the state you live in, and that law can change.

Medicare.gov gives the same advice. Check with your State Insurance Department about what rights you have under state law. That office can tell you if companies in your state must sell to you, may sell to you, or need not sell to you at your age.

Our guide on Medicare under 65 with a disability and the 24-month wait covers how Medicare itself starts for people in your spot.

What to do while you wait for 65

First, call your State Insurance Department. Ask three things. Must a company sell me a policy at my age? If a sale is allowed, are health checks allowed? Is there a set span in which I must apply?

Second, shop with the answer in hand. If your state grants a right, ask each company that sells Medigap in your state what it offers to buyers under 65. Get the terms in writing.

Third, plan the rest of your cover for the years till 65. Original Medicare still pays its share of covered care. You pay the Part B premium of $202.90 per month in 2026 (Ledger A1). For Part B care, you pay the $283 yearly deductible first (Ledger A2), then your share of each bill.

Fourth, check if Medicaid helps in your case. Some people with a disability have both Medicare and Medicaid. Medicaid can pay some costs Medicare leaves. Your state office runs that check.

Fifth, mark the 65 window now. Do not let it slip when it comes. It is the strongest chance you will get to buy any policy sold in your state with no health checks.

The new window at 65

When you turn 65, the rules change in your favor. A fresh Medigap open enrollment period opens for you at 65, keyed to your Part B start at that age.

In that six-month window, a company must sell you any policy it sells in your state, even if you have health problems. It cannot charge you more due to your health in that window.

That is why the call to your state office and the wait both count. If your state gives you no route now, the 65 window is not a hope. It is a set right with a set span. Put the start date on a calendar the year you turn 65.

Who pays for what

Original Medicare pays its share of covered care first. You need Part A and Part B in place for a Medigap policy to sit on top of them.
A Medigap policy, if you can buy one, pays toward the costs Original Medicare leaves, like your share of a bill. It never covers a service on its own.
You pay the Part B premium of $202.90 per month in 2026 (Ledger A1) with or without a Medigap policy.
You pay the Part B deductible of $283 for the year (Ledger A2) as part of your own costs, based on the policy you hold, if any.
Medicaid, for people who qualify through their state, can help with costs Medicare leaves behind.
Private pay covers the rest: the shares and bills no policy pays for you in these years.

Sample situation

Ana is in her late fifties. She has Medicare through a disability. She pays the Part B premium of $202.90 per month in 2026 (Ledger A1). She asks two companies for a Medigap policy. Both say they do not sell to buyers under 65 in her state. She calls her State Insurance Department. The staff tell her what her state law says for buyers her age and what rights, if any, she holds now. She writes down the answer and the name of the person she spoke with. She checks if Medicaid can help with her costs in the years till 65. She also marks her 65th year on her plan. She asks the staff if the state answer is posted on a state page she can save. She saves that page with her Medicare papers, so she can read it again when she shops next. She knows a fresh six-month Medigap window opens then, with no health checks, and she will use it in its first weeks.

What to check in your own case

The wall you hit is real, and it is not your fault. Federal law grants no sale right at your age. State law may grant one, and age 65 grants a full one. Check the state route now, cover the gap years as well as you can, and be ready on day one of the window at 65.

Confirm how you qualified for Medicare: disability or end-stage renal disease. The Medigap gap in this guide turns on that fact and your age.
Call your State Insurance Department. Ask if companies must sell, may sell, or need not sell to you at your age.
Ask if health checks can be used in a sale to you, and if a set application span applies.
Get each offer in writing: the policy letter, what it pays toward, and its terms.
Add up your own costs with no policy: the Part B premium (Ledger A1) and the Part B deductible (Ledger A2) are the fixed base.
Ask your state Medicaid office if you qualify for help with Medicare costs.
Put your 65 window on a calendar now, so the six months do not pass by.