When Do I Have Guaranteed Issue Rights For Medigap?
When you have Medicare there are only a few periods that you have guaranteed issue rights for Medigap insurance. The first period that you have guaranteed issue rights for Medigap policies is when you first become eligible for Medicare. You have 6 months from the time you are eligible and purchase Medicare part B to enroll into a Medigap policy without underwriting issues. The second time that you have guaranteed issue rights for Medigap insurance is if you no longer have a Medicare Advantage plan. If you cancel our Medicare Advantage plan or the company no longer issues your policy you have 63 days from the last day of service to enroll risk free into a Medigap policy. However, you only have this right if you switch to regular Medicare and not another Medicare Advantage plan.
Are There Any Other Times I have Guaranteed Issue Rights For Medigap Insurance?
You will also have rights during your trial period with Medicare Advantage. If, during that trial period you change your mind and decide on regular Medicare you can purchase Medigap insurance without penalty. Due to the economy, many companies have gone out of business in the last few years. If you loose your coverage due to a company going bankrupt or closing you have guaranteed issue rights. Finally, if you were deceived by a Medigap provider who did not pay claims that they said they would or provide coverage you have protected rights. With this last scenario however, you will need to keep all the documents to prove that this happened.
My State Offers Open Enrollment Once A Year Is That Protected?
States have the right to enforce certain aspects of insurance law, including those associate with Medicare. If your state offers open enrollment it is assumable that you will be offered the same protections as if you were initially applying for Medigap coverage.
3 Responses to “When Do I Have Guaranteed Issue Rights For Medigap?”
Leave a Reply to John Lowden
Medicare’s special publication, “Choosing a Medigap . . .” (pages 23-24) contains chart that illustrates guaranteed issue rights. In two of the Trial Rights periods, a “NOTE” indicates there can be a 12-month ‘extension’ of a Medicare Advantage plan due to special circumstances. Can you advise what these ‘special circumstances’ could be that allow a Medicare Advantage policyholder a 12-month ‘extended’ period? Does this 12-month ‘extension’ period also continue the guaranteed issue rights protection the Trial Periods insure?
If I understand you correctly, I think you are referring to “trial period”. If you are new to medicare and join a Medicare Advantage, you have 12 months in which you can drop it and join a medigap policy and cannot be turned down, this is often referred to SEP-65. In this situation you don’t have to wait for any kind of annual enrollment period.
The other situation is if you are dropping a medigap policy (at any age 65 or older) and joining a medicare advantage for the first time and then you decide within the first 12 months that you want to go back to your medicare supplement, you may go back to it on a guaranteed issue basis with the company you were with. If that company no longer offers that same plan, then other companies must take you (at least on certain plans).
Note: this is in order to get a medigap policy back on a guaranteed basis, if you desired to take one out with another company and NOT use your guarantee issue priviledge, you would have to pass underwriting and some companies think you have to use the original company if the same pan is still available, but I disagree.
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