What Are Medicare Supplement Guaranteed-Issue Rights?
Guaranteed-issue rights enable seniors to purchase Medicare Supplement coverage without any underwriting practices or health screenings by Medigap insurers.
Seniors have a guaranteed right if they experience a qualifying event, such as losing a job-based health insurance plan, moving to a new state and losing Medicare Advantage plan coverage, losing Medigap coverage due to an insurer’s insolvency, or turning 65 and enrolling in Original Medicare.
These rights give seniors the right to purchase any Medigap plan at the same rate as a healthy person in their age bracket.
Who Qualifies For Guaranteed Issued Rights?
Any senior who meets the Medicare Supplement Guaranteed-Issue Right qualifications will be eligible to enroll in a Medigap plan regardless of health history.
The qualifying events include:
- Losing a job-based health insurance plan: If a senior loses their job-based health insurance, they can purchase a Medicare Supplement insurance plan without underwriting practices.
- Moving to a new state and losing Medicare Advantage plan insurance coverage: Beneficiaries who move to a new state and consequently lose their Advantage plan health coverage are entitled to the Medicare Supplement Guaranteed-Issue Rights.
- Losing Medigap coverage due to an insurer’s insolvency: If an insurer goes insolvent and a senior loses their Medigap coverage, they can purchase a new Medigap plan under the rights.
- Turning 65 and enrolling in Medicare: Upon turning 65 and enrolling in Medicare, seniors automatically receive the Medicare Supplement Guaranteed-Issue Rights, allowing them to purchase any Medicare supplement plan at the same rate as a healthy person in their age bracket.
How Long Do Medicare Supplement Guaranteed-Issue Rights Last?
Medicare Supplement Guaranteed-Issue Rights are available for 63 days following the qualifying event. If you miss this timeframe, you can still obtain a Medigap policy; however, it is important to note that you may be subjected to medical underwriting. This means there is a possibility of being denied coverage or charged higher premiums.
What Is The Benefit Of Medicare Supplement Guaranteed-Issue Rights?
Guaranteed-issue rights are invaluable as they safeguard seniors from being denied coverage solely based on pre-existing conditions. This means insurers are prohibited from charging higher premium rates for Medicare coverage based on health problems or pre-existing conditions.
Additionally, seniors can select any Medicare supplement policy without limitations or exclusions, choosing from those available at the time. This right also reassures seniors that, regardless of their health status, they will have access to a Medigap plan that helps cover some of the costs not covered by Medicare.
Bottom Line
Medigap Guaranteed-Issue Rights are an essential component of Medicare. When seniors experience a qualifying event, these rights provide options that prevent Medigap insurance companies from underwriting policies or charging more based on pre-existing conditions.
Seniors can use these rights to purchase any Medigap plan, even if they have pre-existing conditions. This means that seniors can rest easy knowing they will always have a Medigap plan available, ensuring they can access the healthcare services they need to lead healthy, happy lives.
Sources: Medicare.gov – KFF – HHS.gov – Medicare Interactive
FAQ's
- What is the difference between open enrollment and guaranteed issues?
- Do I have to pay extra for the guaranteed issue?
