What Are My Guaranteed Issue Rights?

Guaranteed Issue Rights (or Medigap Protections) are the rights you have in certain situations where insurance companies are required by law to sell or offer you a Medicare supplement insurance plan.

Even if you have preexisting conditions, companies cannot deny you Medigap coverage during these periods. Not only must companies offer you a supplement plan, but the plans they offer must cover your preexisting conditions without raising the premiums you’d be paying if you didn’t have any preexisting conditions.

Typically, guaranteed issue applies when you have other health coverage that changes in some way.

For example, if you are enrolled in a Medicare Advantage plan that is leaving your area (or leaving Medicare altogether), guaranteed issue gives you the right to purchase a Medigap plan to replace your Medicare Advantage coverage. In this instance your guaranteed issue rights will not apply if you choose to replace your Medicare Advantage plan with another Medicare Advantage plan. To retain your guaranteed issue rights, you will need to switch from Medicare Advantage back to Original Medicare (Medicare Part A and Medicare Part B).

It’s important to realize that guaranteed issue rights may apply only to certain Medigap plans in some parts of the country. In some states the guaranteed issue right may give you the option of purchasing only certain Medicare Supplement Insurance plans such as Plans A, B, C, F, K, and L. You will need to refer to your state guidelines for more clarification.
Other circumstances leading to guaranteed issue include:

Moving out of your Medicare SELECT policy’s service area when you have both Original Medicare and Medicare SELECT coverage
Losing Medigap coverage through no fault of your own
Dropping Medigap or Medicare Advantage coverage because the company selling you the plan misled you or hasn’t lived up to the agreement or followed the rules

Visit Medicare’s Information Page for more information about further situations in which your guaranteed issue rights will apply. Also note that in some situations you will have a “trial right” allowing you to choose a Medicare Advantage Plan while retaining the option to purchase a Medigap policy if you change your mind.

In general, guaranteed issue rights last 63 days from the date current coverage ends or the date of notice that coverage will end. Medicare supplement insurance companies may not require waiting periods before new coverage begins. To be eligible for guaranteed issue, you must provide proof that you’ve lost or are losing health care coverage.

If you have questions about your guaranteed issue rights or Medigap in general, contact MedicareMall now and we’ll lead you with confidence through the Medicare maze!

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