Medicare Insurance Guaranteed issue right under the Medigap program refers to certain situations where by law, companies are required to offer you a Medicare supplement insurance plan regardless of your health status.
Even if you have pre-existing conditions, Medicare Supplement Insurance Plan companies cannot deny you coverage during these periods. Not only must companies offer you a plan, but the plans they offer must cover your pre-existing conditions without raising premiums.
Likewise, if you already have a policy, you have rights to protect yourself from being forced to keep a plan that is not right for you and in certain situations; you may have an additional guaranteed issue right available to you.
What Situations Trigger Medicare Guaranteed Issue Rights?
|Situation||What Plans Can You Buy?|
|You are in a Medicare Advantage plan, and:||Medigap Plan A, B, C, F, K, or L|
|You have Original Medicare (Part A and Part and a group health plan (including retiree or COBRA coverage), and:||Medigap Plan A, B, C, F, K, or L|
|You have Original Medicare and a Medicare SELECT policy, and:||Medigap Plan A, B, C, F, K, or L|
|You have a Medigap policy, and:||Medigap Plan A, B, C, F, K, or L|
|You leave your Medicare Advantage plan or cancel your Medigap policy because:||Medigap Plan A, B, C, F, K, or L|
In these situations, an insurance company:
- Must sell you a Medigap policy.
- Must cover all your pre-existing health conditions.
- Can’t charge you more for a Medigap policy because of past or present health problems.
In most cases, you have a guaranteed issue right when you have other health coverage that changes in some way. Additionally, individuals enrolled into a Medicare Supplement Insurance Plan have a period of time (this varies by state but typically it is 30 days) when they are first enrolled in what is known as a “free look period”. During this period, you can decide whether or not you wish to keep your new plan.