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.