Underwriting is the process assessing risk of issuing insurance. Undewriters evaluate applications,
Depending on the time in which you decide to apply for a Medicare supplement plan, you might have to undergo medical underwriting. This could be troubling, especially in the event that you have any type of pre-existing condition. However, if you happen to apply during the time period in which you have guaranteed issue rights, you will typically not be turned down from coverage due to your health history.
Guaranteed Issue Rights
There are certain situations where you have rights in which insurance companies cannot deny you Medigap coverage or policies. These rights are known as guaranteed issue rights. For individuals purchasing their Medigap policy outside of their Open Enrollment Period, a company might charge you more for coverage or deny you coverage. This denial would be completely due to current or past health conditions. If you have guaranteed issue rights, an insurance company must cover your pre-existing conditions. They cannot charge you more or deny you Medigap coverage.
When Do I have Guaranteed Issue Rights?
Most individuals typically have guaranteed issue rights during their six-month Open Enrollment Period. During this period, you can purchase any Medicare supplement policy your state offers, regardless of your pre-existing health conditions.
There are some situations in which individuals might have guaranteed issue rights and be outside of their Open Enrollment Period. For example, if you had health care coverage that changed or if you lost coverage and you were not at fault, insurance companies must follow the same guaranteed issue rights policy and grant you coverage. They cannot turn you down or charge you more for coverage based on your current or past health conditions.
Some states, such as Massachusetts, Minnesota, and Wisconsin, have different qualifications. These states have their own versions of Medigap plans, and their rules of coverage may vary. It’s important to contact your local state insurance department if you reside in one of these states.
Guaranteed Issue Rights vs. Guaranteed Issue Trial Rights
For basic guaranteed issue rights, you may not be able to purchase any Medicare supplement plan you want, depending on your individual situation. For example, if you are currently in a Medicare Advantage plan and you move out of your plan’s service area, you can only purchase Medigap Plans A, B, C, F, K, or L. As usual, you must have Original Medicare if you want a Medicare supplement plan, and you can’t have a Medigap policy if you want to join another Medicare Advantage plan.
However, for guaranteed issue trial rights, the rules vary. For example, if you wanted to switch back to Original Medicare within the first year of joining Medicare Advantage (only if you joined when you were first eligible for Medicare), you are eligible to buy any Medigap plan sold in your state. In most cases, trial rights offer you more options for coverage.
Medicare Supplement Rights
Each state provides guidelines to keep every individual searching for Medigap policies protected. If you are curious about the Medigap rights you have in your state, you can contact your State Health Insurance Assistance Program. They can confirm your qualification for guaranteed issue rights.
Additionally, if you are denied Medigap coverage and you have questions or concerns about your denial or rights, you can contact your State Insurance Department and they can further assist you.
Buy a Medicare Supplement Plan
You might still be within your guaranteed issue rights, or you may not qualify and have to undergo medical underwriting. Either way, it is still worth it to try to get a Medicare supplement plan. When you are ready, you can get your free Medicare supplement quote online.
If you are still within a period in which you may have guaranteed issue rights, you might need to prove it. If you have any official documentation of the reason why you are switching policies (i.e., a statement saying your previous coverage is ending), it is important to present this to ensure you are not turned down or charged more for coverage.
There are many more situations in which an individual may have guaranteed issue rights or guaranteed issue trial rights. To learn more, feel free to contact one of our knowledgeable Medicare supplement agents. We’re available at (800) 310-3550 and we would be more than happy to assist you.