What are Guaranteed Issue Rights With Medicare?

An unfortunate situation beneficiaries can often find themselves in is being subject to underwriting. Underwriting is when an insurance company gathers information about you, and can then hike up the price of your premiums, or even deny you coverage entirely, because of pre-existing conditions. Because of underwriting, beneficiaries may be left without the insurance they need to take proper care of their health.

Guaranteed issue rights are a way to circumvent underwriting. Guaranteed issue rights cover a range of specific situations that will require insurance companies to allow you to purchase a Medicare Supplement, also known as Medigap, regardless of any pre-existing conditions, and they cannot charge you extra.

Types of Guaranteed Issue Rights

You are protected by guaranteed issue rights if the following circumstances apply to you:

  • You were insured by an employer, and that insurance is now ending. You must enroll in Medicare Part A and Part B before purchasing a Medigap policy. You have 63 days after the last service day of your employer insurance for this to apply.
  • You have group insurance that is being discontinued.
  • You are dropping a Medicare Advantage plan. In order to be eligible for this guaranteed issue right, you must be within the first year of enrolling in Medicare Advantage.
  • You are leaving the area of coverage for your Medicare plan. This applies to Medicare Advantage and Medicare SELECT.
  • Your current Medicare plan no longer services your area.
  • Your Medicare and/or Medigap plan is in violation of your agreed-upon rights of service.
  • Your Medigap policy is discontinued through means you have no control over.

In some of the above circumstances, you may be required to provide documentation as proof of your guaranteed issue right. Speak with your insurance provider to see what is needed for you to purchase your supplement insurance without the risk of underwriting.

Best Way to Avoid Being Denied Coverage

Keep in mind, while some situations are out of your control, the best way to avoid being denied coverage by insurance companies is to purchase your Medigap plan as soon as you enter your Medigap Open Enrollment Period. This period starts as soon as you have Original Medicare and will last for a total of six months. You will have guaranteed issue rights during this period.

Medigap also allows beneficiaries a trial period of 30 days to see how they like their policy. If you try out a policy and decide it’s not for you, you can drop it and have your premium refunded. Do your research and make sure to find a policy that is tailored to fit your health care needs.

Find a Medigap Plan Today!

If you are enrolled in Medicare and are interested in buying a Medigap plan, give us a call today! We are here to help you get the coverage you need at the right time!