Guranteed Issue Rights are the rights you have in certain situations when insurance company MUST offer you certain Medigap policies, and you are NOT a subject to medical underwriting used to decide whether to accept your application, to charge more for the policy, or to impose its regular (up to six months) pre-existing conditions waiting period. Do you have Medicare Supplement Guaranteed Issue?
Medigap Open Enrollment Period
The best time to enroll in a Medicare Supplement is during the Medigap Open Enrollment Period – a six month period after you’ve enrolled in Medicare Part B. During this period an insurance company cannot use medical underwriting:
- They cannot refuse to sell you a Medigap policy
- They cannot charge you more due to existing health problems
- They cannot make you wait for coverage to start, as long as you have at least six months of prior creditable coverage when you first enroll in a Medigap and have had this prior coverage within the last 63 days
In Medigap Open Enrollment Period you have the right to buy ANY Medigap policy offered in your state.
If you apply for a Medigap policy at any other time, the insurance company is allowed to use medical underwriting to decide whether to accept you. Guaranteed Issue Rights is an exception from this rule.
Medicare Supplement Guaranteed Issue
If you entitled to Guaranteed Issue, an insurance company must
- Sell you a Medigap policy
- Cover all your pre-existing health conditions
- You can’t be charged more for a Medigap policy regardless of past or present health problems.
The events when you are entitled to Guaranteed Issue for Medicare Supplement are described below:
- You’ re in Medicare Advantage Plan, and your plan is leaving Medicare or stops provide service in your area
- You have Original Medicare and an employer group health plan that pays after Medicare, and that plan is ending
- You have Original Medicare and a Medicare SELECT policy. You move out of the Medicare SELECT policy’s service area.
- You joined a Medicare Advantage Plan when you were first eligible for Medicare Part A at 65, and within the first year of joining, you decide to switch back to Original Medicare (Trial Right)
- You dropped a Medigap policy to join a Medicare Advantage Plan for the first time, you have been in the plan less than a year, and you want to switch back (Trial Right)
- Your Medigap insurance company goes bankrupt and you lose your coverage
- You leave a Medicare Advantage Plan or drop a Medigap policy because the company hasn’t followed the rules, or it misled you.
You have the right to buy Medigap Plan A, B, C, F, K, or L that is sold in your state by any insurance company.
Typically, you can apply for a Medigap policy as early as 60 calendar days before the date your coverage will end, but not later than 63 calendar days after your coverage ends.
Periodically, an insurance company may offer one of the Standardized Medicare Supplement plans as Guaranteed Issue without any need triggering one of the events described above. This is normally done in order to promote a particular Medigap plan.
For more information, see Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare.
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For help finding whether you have Medicare Supplement Guaranteed Issue, please contact Liberty Medicare or call us at 877-657-7477.