If you enrolled in Original Medicare (Part A and Part B) and you think you want coverage with Medicare Supplement Plans, it’s important to apply when you have Medicare Supplement guaranteed issue rights. These rights, also called Medigap protections, give you the best opportunity to buy the plan you want at the most affordable price. Read on for a breakdown of Medicare Supplement guaranteed issue rights and how they affect you.
What are Medicare Supplement guaranteed issue rights?
Medicare Supplement Plans are actually private insurance plans sold by private companies approved by Medicare. Although plan benefits are determined and standardized by the federal government, private insurers generally have the final say about who they will cover and at what price—unless you have Medicare Supplement guaranteed issue rights.
When you have Medicare Supplement guaranteed issue rights, the insurance company must sell you any Medicare Supplement plan sold in your state, regardless of your health history. The insurer must also cover your pre-existing conditions. Finally, the company cannot increase your premiums if you have a serious health condition; they generally must sell you the plan at the same premium they charge anyone else.
If you plan to buy one of the Medicare Supplement Plans available in your state, you should generally do so when you have guaranteed issue rights.
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Can I buy Medicare Supplement Plans without guaranteed issue rights?
It’s impossible to say whether or not a company will sell you a plan without Medicare Supplement guaranteed issue rights. Most companies will make you pass medical underwriting before offering you a plan. During medical underwriting, the insurer can look at your past medical history and medical records. If you have serious or chronic health conditions such as diabetes, heart disease, or COPD, they may decide not to issue you a policy.
Depending on your health history, they could also sell you a different plan with less comprehensive coverage, or they could impose a waiting period on pre-existing conditions. They could also offer to sell you a plan, but charge you more than they charge others.
When do I have Medicare Supplement guaranteed issue rights?
The Open Enrollment period for Medicare Supplement Plans starts when you are both age 65 or older and enrolled in Part B, and lasts for six months. Everyone has guaranteed issue rights during that six-month period.
Outside of Open Enrollment, you may have guaranteed issue rights for a short period of time related to certain special situations. For example:
- If you have Medicare Advantage, and your plan is no longer operating in your area, or you move out of your plan’s service area, you have a window of time with guaranteed issue rights to buy Medicare Supplement Plans.
- If you joined Medicare Advantage when you first became eligible for Medicare, but decided to switch to Original Medicare within the first 12 months, you have Medicare Supplement guaranteed issue rights for 60 days before your plan ends and 63 days after you switch.
- If you dropped a Medigap plan to enroll in Medicare Advantage, but decide within 12 months to switch back (known as “trial right”), you have Medicare Supplement guaranteed issue rights for the same four-month period described above.
- If you joined a Medicare Advantage plan or bought a Medicare Supplement Plan, but the plan doesn’t follow Medicare rules or behaved unethically, you may also have short-term guaranteed issue rights.
Your window for Medicare Supplement guaranteed issue rights may vary depending on the situation; be sure to check the timeframe for your specific circumstance. Also, in some cases, you may be limited to just a few Medicare Supplement Plans. In other words, in certain situations where you have Medicare Supplement guaranteed issue rights, it may not apply to all available plans.
To look for a Medicare Supplement plan in your area, enter your zip code on this page.
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