What is a Medicare Supplement Guaranteed Issued Right?

You may be reaching the age where you are eligible for Medicare insurance. As a Medicare beneficiary, you may have a right to apply for Medicare Supplement coverage called Medicare Supplement guaranteed issue rights.

Guaranteed issue rights are rights that you have in situations where insurance companies must offer you certain Medigap policies.

Guaranteed issue rights are guaranteed for qualifying time periods or events that allow a Medicare beneficiary with certain prior coverage to apply for a Medicare Supplement policy without underwriting or having to answer health questions. A Medicare Supplement insurance company must follow these requirements:

1. You cannot be denied purchase of a Medicare Supplement insurance policy.
2. Due to health conditions or claims experience, your pre-existing health conditions don’t apply under the policy.
3. You cannot be charged extra for a Medicare Supplement insurance policy because of past or present health problems.
4. If you have certain other health coverage and it changes, you may have a right to apply for a guaranteed issue Medicare Supplement policy.

Events or situations where guaranteed issue rights apply

1. You have applied for Medicare Supplement insurance at age 65 and within seven months of the initial open enrollment, including Medicare Part B enrollment. This has termed your Medicare Supplement Open Enrollment Period.
2. You’re in a Medicare Advantage Plan. This plan is leaving Medicare or stops giving care in your area, or you move out of the plan’s service area. If you choose to switch to Original Medicare and get a Medicare Supplement policy, rather than joining another Medicare Advantage Plan, you must end the Medicare Advantage plan first. ¹
3. You have Original Medicare and an employer group health plan (which may include retiree or continued COBRA coverage), or union coverage that pays after Medicare pays, and the plan is ending.
4. You have Original Medicare and a Medicare SELECT policy. You moved out of the Medicare SELECT policy’s service area.
5. You joined Medicare Advantage Plan of All-inclusive Care for the Elderly (PACE) when you were first eligible for Medicare Part A at 65, and within the first year of joining, you decide you want to switch to Original Medicare. This is considered a trial period.
6. You dropped a Medicare Supplement insurance policy to join a Medicare Advantage Plan (or switch to a Medicare SELECT policy) for the first time; you’ve been on the plan less than a year, and you want to switch back. This is considered a trial period. You have a right to buy Medicare Supplement insurance.
7. Your Medicare Supplement insurance company goes bankrupt, and you lose your coverage, or your Medicare Supplement insurance policy coverage otherwise ends through no fault of your own.
8. You leave a Medicare Advantage Plan or drop a Medicare Supplement insurance policy because the company hasn’t followed the rules, or it misled you.

Medicare Supplement insurance plans and enrollment

Under the situations listed above, you have the right to buy Medicare Supplement insurance Plans A, B, C^*, D, F^*, G, K, and L, sold by any insurance company in your state. **

In general, all situations listed above have a time limitation of a Medicare Supplement insurance policy enrollment under the Guaranteed Issued Right. It is:

1. As early as 60 days before the date of your eligibility for coverage
2. No later than 63 calendar days after your eligibility for coverage ends

NOTE: **Regarding Plans C and F: They are no longer available to people who are new to Medicare on or after January 1, 2020. However, if you were eligible for Medicare before January 1, 2020, but you have not yet enrolled, you may be able to buy Plan C or Plan F. People eligible on or after January 1, 2020, have the right to buy plans D and G instead of Plans C and F.

1. https://www.medicare.gov/supplements-other-insurance/when-can-i-buy-medigap/guaranteed-issue-rights
2. https://www.dol.gov/general/topic/health-plans/cobra