A Medicare supplement, also known as a Medigap policy, is a private health insurance used in conjunction to a Medicare policy. This policy will pay many of the health care costs that are not covered by Medicare including deductibles, coinsurance and co-payments. A pre-existing condition is a health condition that existed before applying to a health insurance. Examples of pre-existing conditions are hypertension, diabetes, chronic obstruction pulmonary disease (COPD), etc.
When buying a Medicare supplement, there are a few guidelines to adhere to. You must have Medicare Part A and Part B. This policy will only cover you; your spouse will have to purchase their own policy. These policies do not cover prescription drug costs; you will need to purchase a separate prescription drug plan.
The best time to purchase a Medicare supplement, when you have a pre-existing condition, is during the open enrollment period. This period lasts for 6 months, beginning the first day of the month when you are 65 and enrolled in Medicare part B. During this period, an insurance company cannot make you wait before coverage to begin or charge you a higher premium for a pre-existing condition. If you are changing your Medicare supplement policy and have six months of continuous coverage, you cannot be held to the pre-existing coverage waiting period. You also have “guaranteed issue rights” in which the insurance company is required by law to offer a policy, cannot charge a higher premium and must cover any pre-existing conditions.
Guaranteed issue rights occur when several factors exist, allowing you to change your Medicare supplement despite having a pre-existing condition.
• Your current policy is leaving Medicare, suspends coverage in your area or you move.
• Your employer group health plan is ending.
• You decide to switch within the first year of joining a Medicare Advantage plan.
• Your Medicare supplement plan goes bankrupt and you lose coverage.
• You decide to switch plans because your Medicare supplement plan mislead you or hasn’t followed the rules.