Medigap Guaranteed Issue Rights
Even if you are no longer in your Medigap or Medicare Supplement open enrollment period, there are situations in which you still have a guaranteed right to buy Medicare Supplement insurance. In these situations, an insurance company must sell you a Medigap policy (plan choices may be limited), must cover all of your pre-existing conditions, and can not charge you more for your policy because of health problems.
When Are Guaranteed Issue Rights Granted?
In most situations, you have guaranteed issue rights if you have other health care coverage that is changing in some way, or you are losing this coverage. Here is a summary of these situations:
#1: You are enrolled in a Medicare Advantage Plan, and this plan is leaving the Medicare Program or stops servicing your area, or you are moving out of your plan's service area.
#2: You have employer health coverage or union coverage that pays after Medicare pays, and that coverage is ending.
#3: You have a Medicare SELECT policy, and you are moving out of the plan's service area. You can keep your Medigap policy or switch to another Medigap policy.
#4: (Trial Right) You enrolled in a Medicare Advantage Plan or PACE when you were first eligible, and within your first year of joining, you wish to switch to the Original Medicare Plan.
#5: (Trial Right) You dropped a Medicare Supplement policy (Medigap policy) to join a Medicare Advantage Plan (or to switch to a Medicare SELECT policy) for the first time; you have been in the plan for less than a year and you want to switch back.
#6: Your Medicare Supplement insurance (Medigap) company goes bankrupt causing you to lose coverage, or your Medigap policy coverage ends through no fault of your own.
#7: You decide to drop a Medigap policy or leave a Medicare Advantage Plan because the company hasn't followed the rules or misled you.
Additional Medigap Protection
The guaranteed issue rights listed on this page are from from Federal law. Many states include additional Medigap rights. Also, it is possible that more than one of these situations applies to you. If so, choose the guaranteed issue right that gives you the best choices of available plans for your situation. For more information on qualifying, call your State Health Insurance Assistance Program.