The ABCs of Medicare Supplement Plans

Part four: Medigap guaranteed issue rights

Now that you meet all the requirements to get a Medicare Supplement Plan and you are able to enroll during the 6-month period, you may want to know a little bit more about the Medigap guaranteed issue rights. This can also be helpful if you missed the 6-month period and want to know about the situations in which you can get Medigap outside the enrollment period. In this article we will cover those guaranteed issue rights.

     What are Medigap guaranteed issue rights?

The Medigap guaranteed issue rights, also known as Medigap protections, are the rights you have when applying for a Medigap policy that protects you from being denied coverage, by federal law. Once you already a plan, you also have the rights of being protected from having to keep a plan that is not right for your necessities.

As we already said, you have the right to buy a Medigap policy during your 6-month Medigap open enrollment period and this is best time to do it. However, there are certain situations outside this period when you may still be able to get a Medigap policy if you are 65 or older, according to Medigap guaranteed issue rights.

Generally speaking, you can buy a Aetna Medicare supplement Plan G when one of the health-care coverages that you already own changes in some way. For example, losing the health-care coverage. In this case, you have the guaranteed issue right to buy a Medigap policy. The insurance company is obligated to sell you one of the plans, to cover you pre-existing health conditions and you cannot be charged more despite those conditions. Remember that in Massachusetts, Minnesota, or Wisconsin they have other types of Medigap policies and some of the options below may not apply.

     You qualify for these rights in the following situations:

  • You’re in a Medicare Advantage plan and your plan loses its contract with Medicare, it is discontinued in your service area or you move out of the plan’s service area. In this case you must switch back to Original Medicare and you can buy Medigap Plans A, B, C, F, K, or L. Remember you cannot have a Medicare Supplement Plan and a Medicare Advantage  plan, so you cannot buy a Medigap if you join another Advantage plan.
  • You have Original Medicare (Part A and Part B) and a group health plan (including retiree or COBRA coverage) that pays after Medicare, and Medicare is your primary payer or your group coverage is ending. In this case you can apply for Medigap no later 63 calendar days after the date your coverage ends or the date you get of the notice about the end or a claim denial. You can buy Medigap Plans A, B, C, F, K, or L.
  • You have Original Medicare and a Medicare SELECT policy and you move out of the Medicare SELECT policy’s service area. In this case you can buy Medigap Plans A, B, C, F, K, or L.
  • You have a Medigap policy and your insurance company goes bankrupt and you lose your coverage or your coverage ends for reasons that are not your fault. In these cases you can buy Medigap Plans A, B, C, F, K, or L.
  • You leave a Medicare Advantage Plan or drop a Medigap policy because the company hasn’t followed the rules, or it misled you. In these cases you can buy Medigap Plans A, B, C, F, K, or L.

In the previous cases, you must apply for the Medigap policy as early as 60 days before the date your coverage will end (if you previously know that the coverage will end for any of the reasons mentioned above) or no later than 63 calendar days after your coverage ends.



Getting Medical Cost Coverage after Attaining Golden Age Of 65

Gradually as you are approaching the golden age of 65 you must have started realizing the gift that this age gives to your health. There are health problems and Doctor’s prescription are not something new! Till date you must have been comfortable with the private insurance provide by your work place but now when you are about to retire what about these health expense, especially when they are going to increase?

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Medicare- your health insurance after 65

Medicare is a federal program that was started in 1965 and it mainly aims in providing financial security for those who are undergoing medical treatment after attaining the age of 65. For many it may seem very complex with its different parts and terminologies. Part A and Part B are the integral part of Medicare and they come in automatically once you get enrolled. Part A is for inpatient coverage and Part B is for outpatient coverage.

Apart from this there are other plans under Medicare like the Medicare Advantage plan and Medicare supplement plans that fills in the gap where Original Medicare do not take care. There are many expenses that are not covered under Part A or Part B and in order to meet those expenses you need to take Medicare Supplement Plans. These plans are offered by private insurance companies but they are governed by the Federal government.

 Medicare Supplement Plans – supports your health expenses

If you are ill for a short period then your original Medicare will be enough to cover your medical bills, but by any chance when it increases then you have to pay the extra costs out of your pocket. Like, if you are in hospital for more than 80 days then Part A will cover a part of the cost during the stay. Similarly, Part B will cover only 80% of the medical services you take while you are ill. The rest of the costs must be borne by you as copayment or coinsurance.

If you have spouse who is still working and gets coverage on the other expenses then it is fine you will not need Medigap. For others a Medigap plan is essential as it covers those expenses that are not covered by the Part A and part B of original Medicare. There are 10 different types of plans available under this plan and you need to be careful while choosing one for your need.