If you are new to Medicare, you may have heard that in some situations you may be able to get a “Guaranteed Issue” Medigap Policy (“Medicare Supplement”), for example, during your open Medigap registration phase. Many people with Original Medicare choose Medigap coverage to cover certain costs that are not covered by Parts A and B, such as co pays, co insurance, deductibles, or emergency insurance abroad.
If you have a health problem that could make hiring additional Medicare insurance difficult, it is especially important to know in which situations you can have guaranteed issue rights. Here is a general description of how Medigap works with guaranteed results and the times when you may be eligible.
What are the issue rights guaranteed by Medigap?
In a nutshell, “guaranteed issue rights” are Medigap protections that entitle you to participate in a Medicare supplement policy offered by an insurance company in your state, irrespective of your health status.
If you have guaranteed issue rights, the insurance firm that sells the Medicare supplement policy:
- must insure all your existing conditions; though, in some cases you may have to wait up to 6 months before these conditions are met.
- cannot ask for medical underwriting.
- for health reasons, cannot overcharge your policy
- cannot refuse your coverage
* Please note that the insurance company may request higher premiums for other purposes, depending on how they choose the Medigap premium. Without guaranteed protection, you may find it more difficult to obtain the Medigap policy you want, especially if you have health problems. The insurance company may request medical insurance and may consider the results when deciding whether or not to issue a policy. If you find a Medigap policy, you may have to pay more. Or you could refuse coverage completely.
When can I buy a guaranteed issue Medigap policy?
One of the best times to sign up for a guaranteed issue Medigap policy is the open enrollment period for the Medicare supplement. This is the 6-month period that automatically starts when you are 65 years or older and has Part B. Once your Medigap Open registration period ends, you cannot try again and you will not be able to recover it.
The Medigap Open Enrollment Period is not the only time you have guaranteed issue rights. In certain situations, you may be eligible to receive a guaranteed supplement Medicare supplement policy (for example, if the insurance company that offers your policy goes bankrupt). The Medigap open enrollment period however, is a good time to enroll in Medicare supplemental insurance. The reason is because it is an established and fixed time frame which confers on you the legal right to any Medigap policy provided by any insurance firm in your service area. At the expiration of your Medigap open enrollment period, you will not be guaranteed this right unless you are in a qualifying situation and may not be eligible for a Medicare supplement if you already have existing terms.