Whether you’ve already decided on a Medicare Supplement insurance policy or you’re still weighing your options, you have to purchase your plan at the right time. Learn everything you need to know about Medicare Supplement user rights, and discover the key differences between open enrollment and guaranteed issue. Show
Medicare Supplement Open EnrollmentEvery Medicare recipient has what’s known as a Medicare Supplement Open Enrollment Period. This lasts for six months and starts on the first day of the month when you’re at least 65 years old and enrolled in Medicare Part B. Because the start of this six-month period requires you to enroll in Part B, the timing might differ from your Medicare initial enrollment period, which begins three months before your 65th birthday. During your Medicare Supplement Open Enrollment Period, you’re able to purchase any Medigap policy that’s available in your state. The 10 standardized Medigap policies are available in 47 states, with Massachusetts, Minnesota, and Wisconsin offering slightly different options. The benefits of buying a Medigap plan during open enrollment are twofold. Not only do insurance companies have to sell you any policy that’s available in your state but they also have to charge you a standard rate. That means providers can’t require you to pay more due to your age or a pre-existing condition. Not everyone chooses the right Medigap plan on the first attempt. If you want to purchase the same plan from a different provider or you want to change the plan entirely, you can apply for a new plan at any point during the year. If this occurs outside your initial period, you will have to answer health questions to qualify for coverage. How do I know which enrollment period applies to me?Medicare Supplement Insurance Guaranteed IssueCertain situations can occur that cause you to have what’s known as a guaranteed issue right. These rights ensure that you can get the health care coverage you need. When your guaranteed issue rights are in effect, providers have to:
Guaranteed issue rights apply to several situations. You can exercise your rights in the following scenarios:
Your Medicare Supplement Insurance company goes bankrupt or otherwise stops your coverage at no fault of your own. Can You Purchase Medicare Supplement Insurance At Other Times?You might be able to purchase a Medigap policy outside of your open enrollment period and when you don’t have guaranteed issue rights. This depends entirely on your health status and the insurance company you choose. If you don’t have an open enrollment period or guaranteed issue rights, insurance companies may use medical underwriting to determine whether to take your application or grant you a policy. Different Medicare Supplement insurance carriers have different underwriting standards. If you are denied coverage by one carrier, you may still be eligible for coverage with a different one. This is a situation where having an independent agent is huge since they can help you apply for coverage with a variety of Medigap insurance carriers. For some retirees, it’s worth the effort to purchase a Medigap policy after the open enrollment period and outside of any special conditions. If you’re faced with this decision, take the time to compare the premium costs with your anticipated medical bills. With this calculation in hand, you can make the right choice for your budget, healthcare needs, and peace of mind. Guaranteed issue rights, also called Medigap protections, are your rights to purchase Medigap policies when you are not in your Medigap open enrollment period. These rights prevent insurance companies from denying you a Medigap policy or put conditions on buying one in certain situations. 
Fact Checked A licensed insurance professional reviewed this page for accuracy and compliance with the CMS Medicare Communications and Marketing Guidelines (MCMGs) and Medicare Advantage (MA/MAPD) and/or Medicare Prescription Drug Plans (PDP) carriers’ guidelines. Cite Us APA Turner, T. (2022, October 13). Guaranteed Issue Rights. RetireGuide.com. Retrieved October 28, 2022, from https://www.retireguide.com/medicare/supplement-insurance/guaranteed-issue-rights/ MLA Turner, Terry. "Guaranteed Issue Rights." RetireGuide.com, 13 Oct 2022, https://www.retireguide.com/medicare/supplement-insurance/guaranteed-issue-rights/. Chicago Turner, Terry. "Guaranteed Issue Rights." RetireGuide.com. Last modified October 13, 2022. https://www.retireguide.com/medicare/supplement-insurance/guaranteed-issue-rights/. Why Trust RetireGuide.com Content created by RetireGuide and sponsored by our partners. Key PrinciplesRetireGuide’s mission is to provide seniors with resources that will help them reach important financial decisions that affect their retirement. Our goal is to arm our readers with knowledge that will lead to a healthy and financially sound retirement. We’re dedicated to providing thoroughly researched Medicare information that guides you toward making the best possible health decisions for you and your family. RetireGuide LLC has partnerships with Senior Market Sales (SMS), GoHealth, Tranzact and CoverRight. Our partners are able to be reached through the phone numbers and/or forms provided on our website. The content and tools created by RetireGuide adhere to strict Medicare and editorial guidelines to ensure quality and transparency. Editorial IndependenceWhile the experts from our partners are available to help you navigate various Medicare plans, RetireGuide retains complete editorial control over the information it publishes. We operate independently from our partners, which allows the award-winning RetireGuide team to provide you with unbiased information. Visitors can trust our inflexibility regarding our editorial autonomy. We do not allow our partnership to influence RetireGuide’s editorial content whatsoever. What Are Guaranteed Issue Rights?Your guaranteed issue rights under Medicare means that insurance companies have to offer you their Medigap coverage when you are Medicare eligible and your health coverage changes in some major or significant way. Your Guaranteed Issue Rights
These Medigap protections come into play outside the Medigap open enrollment period — the six-month period that begins once you are 65 or older and enrolled in Medicare Part B. When You Have Guaranteed Issue RightsThere are seven situations in which you have guaranteed issue rights. In addition to changes in your health coverage, they include your trial rights — effectively your right to “test drive” a Medicare Advantage plan and still buy a Medigap policy if you change your mind. Medigap Guaranteed Issue Right Situations Medicare Advantage Plan Ends If your Medicare Advantage plan leaves Medicare or you move outside its coverage area, you can switch to Original Medicare and purchase a Medigap policy. You can make the change between 60 days before your Medicare Advantage coverage ends but no later than 63 days after it ends.Group Health Plan Ends If you have Original Medicare and union or employer group health coverage that is ending, you can buy a Medigap policy. You must make the purchase no later than the latest date of three situations: The date your coverage ends, the date you get a notice that the coverage is ending or the date on a claim denial if that’s the only way you were notified your coverage ended.Moving out of a Medicare SELECT Coverage Area You can buy a Medigap policy as early as 60 days before Medicare SELECT coverage ends but no later than 63 days after it ends.Medigap Insurer Goes out of Business If the company that issued the Medigap plan goes bankrupt, or the coverage ends through no fault of your own, you can purchase a Medigap policy sold by any insurance company in your state. But you must purchase it within 63 days of the date coverage ends.Medigap Insurer Breaks the Rules If a company violates rules or regulations or if it misleads you, you can drop a Medigap or Medicare Advantage plan. You can purchase certain Medigap plans sold in your state by any insurance company, but you have to purchase it no later than 63 days after the date your coverage ends.Enrollment Trial Rights You get a 12-month trial of Medicare Advantage when you enroll into Medicare for the first time upon becoming eligible for the first time at age 65. Within the first year of joining, you can decide to switch to Original Medicare.Medigap Policy Trial Rights If you switch from Medigap coverage to a Medicare Advantage plan and want to change back, you can purchase your previous policy — if it’s still available. If it isn’t, you can purchase a Medigap policy from any insurer in your state. But you have to do so within 63 days of when your Medicare Advantage coverage ends.In most states, there are 10 standardized Medigap plans. Under your guaranteed issue rights, you may be able to choose from only some of these Medicare plans in certain situations. If more than one situation applies to you, you have the right to choose the situation that gives you the best choices and options to replace your coverage. These guaranteed issue rights are federal law, but your state may provide more Medigap and Medicare SELECT rights. You can contact your State Health Insurance Assistance Program to find out your rights in your state. Learn more about the benefits of having a Medigap plan from Tom Parkin, a Medicare expert who has more than a decade of experience in the insurance industry. Can You Buy Medigap Without Guaranteed Issue Rights?If you don’t meet any of the situations for guaranteed issue rights to take effect, you may still be able to buy a Medigap policy after your Medigap open enrollment period ends. If you have preexisting conditions, insurers can refuse to sell you a Medigap policy or charge you higher premiums. They can also require a six-month waiting period before covering your preexisting condition. An insurer may also require you to pass medical underwriting exams before deciding to sell you a Medigap policy. During this process, the insurer can examine your past and current medical records to check for chronic or serious medical conditions such as heart disease, cancer and diabetes risks. The insurer can use this information to deny you a Medigap policy. Last Modified: October 13, 2022 4 Cited Research Articles
What is the difference between open enrollment and guaranteed issue?Whereas in open enrollment, you can choose any Medigap plan that is offered in your state, during a guaranteed issue you can typically only choose Medigap Plans A, B, C, F, K or L that's sold in your state by any insurance company.
What is a guaranteed issue plan?A requirement that health plans must permit you to enroll regardless of health status, age, gender, or other factors that might predict the use of health services. Except in some states, guaranteed issue doesn't limit how much you can be charged if you enroll.
What are Medigap guaranteed issue rights?You have a guaranteed issue right (which means an insurance company can't refuse to sell you a Medigap policy) in these situations: You're in a Medicare Advantage Plan, and your plan is leaving Medicare or stops giving care in your area, or you move out of the plan's service area.
How long does a Medicare Supplement insurance guaranteed issue period generally last?If you are age 65 or older, you have a guaranteed issue right within 63 days of when you lose or end certain kinds of health coverage.
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What is guaranteed issue for medicare supplement
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