Guaranteed Issue Periods for Medicare Supplement Plans

Special Enrollment Periods for Medicare Supplement PlansWhat are Guaranteed Issue Periods for Medicare Supplement Plans?

While there are numerous circumstances or situations that create Special Enrollment Periods (also known as “SEP”) that allow enrollment into a Medicare Advantage plan and/or a Prescription Drug Plan, not all of them create Guaranteed Issue Periods for Medicare Supplement plans.  Guaranteed Issue Periods for Medicare Supplement plans occurs when an event creates a guaranteed issue or Open Enrollment Period wherein a Medicare beneficiary can enroll in a Medicare Supplement plan without consideration of pre-existing conditions, age, etc.  In fact, guaranteed issue rights (sometimes called “Medigap protections”) are rights you have in certain situations when insurance companies are required by law to sell or offer you a Medicare Supplement policy even if you have health problems, or pre-existing conditions.  Guaranteed Issue Periods for Medicare Supplement Plans are in addition to the Open Enrollment Period, also known as your Initial Enrollment Period, which begins three months before the  month of your 65th birthday, includes your birth month, and continues three months after your birth month. 

Guaranteed Issue Periods for Medicare Supplement Plans May Have Restrictions With Regard to Which Plan You Can Purchase.

Medicare Supplement Plans are labeled A, B, C, D, F, G, K, L, M and N to signify the plan differences. (Plans E, H, I and J are no longer available.)  Each Medicare Supplement Plan sold during any of the Guaranteed Issue  Periods discussed herein fall under the same rules as Medicare Supplement Plan Open Enrollment Periods — in other words, you cannot be denied coverage based on age, pre-existing conditions, etc. However, certain enrollment periods have restrictions as to which plan you can purchase during a specific Guaranteed Issue Period for Medicare Supplement Plans. 

Remember, because Medicare Supplement Plans  are regulated by state and Federal laws, all benefits for all options are the same regardless of insurer. The differences will be in the price, who administers the plan, and which of the ten options the Medicare beneficiary chooses to purchase.

Guaranteed Issue Periods for Medicare Supplement Plans Have a Set Number of Days.

It is important to note that Guaranteed Issue Periods for Medicare Supplement Plans that create guaranteed issue or Open Enrollment Periods for a certain period of time.  While some Guaranteed Issue Periods for Medicare Supplement Plans coincide with enrollment into Medicare Advantage Plans and/or Prescription Drug Plans, there are fewer Guaranteed Issue Periods for Medicare Supplement Plans. However, it is very important to learn the events that trigger a Guaranteed Issue Period for Medicare Supplement Plans, what you can do, and the set number of days of the enrollment period.

Guaranteed Issue Period for Medicare Supplement Plans:

1.  If you have Original Medicare and an employer group health plan (including retiree or COBRA coverage) or union coverage that pays after Medicare pays and that plan is ending.

Then you can purchase a Medicare Supplement Plan A, B, C, F, K, or L that is sold in your state by any insurance company.  If you have COBRA coverage, you can either buy a Medicare Supplement plan right away or wait until the COBRA coverage ends.

When:  No later than 63 calendar days after the latest of these 3 dates:

      • Date the coverage ends
      • Date on the notice you get telling you that coverage is ending (if you get one)
      • Date on a claim denial, if this is the only way you know that your coverage ended

Guaranteed Issue Period for Medicare Supplement Plans:

2.  You are in a Medicare Supplement Plan or 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.

You can purchase plans A, B, C, F, K or L. 

When:  As early as 60 calendar days before the date your coverage will end, but no later than 63 calendar days after your coverage ends.  Note: Your rights may last for an extra 12 months under certain circumstances.

Guaranteed Issue Period for Medicare Supplement Plans:

3.  You have original Medicare and a Medicare SELECT policy. You move out of the Medicare SELECT policy’s service area.  

You can purchase a Medicare Supplement Plan A, B, C, F, K, or L that is sold by any insurance company in your state or the state you are moving to.

When:  As early as 60 calendar days before the date your health care coverage will end, but no later than 63 calendar days after your health care coverage

Guaranteed Issue Period for Medicare Supplement Plans:

4.  You joined a Medicare Advantage Plan or Programs of All-inclusive Care for the Elderly (PACE) when you were first eligible for original Medicare at age 65, you have a “trial right” which allows you to switch back to original Medicare.

You can purchase any Medicare Supplement Plan  that is sold in your state by any insurance company.

When:  As early as 60 calendar days before the date your coverage will end, but no later than 63 calendar days after your coverage ends.  Note: Your rights may last for an extra 12 months under certain circumstances.

Guaranteed Issue Period for Medicare Supplement Plans:

5.  You purchase a Medicare Advantage plan during your “trial right” which allows you to drop your Medicare Advantage plan and purchase a Medicare Supplement plan if you change your mind within the first 12 months of enrollment in a Medicare Advantage plan.

You can purchase the Medicare Supplement Plan you had before you joined the Medicare Advantage Plan or Medicare SELECT policy, if the same insurance company you had before still sells it.  If your former Medicare Supplement Plan is not  available, you can buy a Medicare Supplement Plan A, B, C, F, K or L that is sold in your state by any insurance company.  

When:  As early as 60 calendar days before the date your coverage will end, but no later than 63 calendar days after your coverage ends.  Note: Your rights may last for an extra 12 months under certain circumstances.

Guaranteed Issue Period for Medicare Supplement Plans:

6.  Your Medicare Supplement Plan’s insurance company goes bankrupt and you lose your coverage, or your Medicare Supplement Plan coverage otherwise ends through no fault of your own. 

You can purchase a Medicare Supplement Plan  A, B, C, F, K, or L that is sold in your state by any insurance company.

When:  No later than 63 calendar days from the date your coverage ends.

Guaranteed Issue Period for Medicare Supplement Plans:

7.   You leave a Medicare Advantage Plan or drop a Medicare Supplement Plan because the company has not  followed the rules, or it misled you.

You can purchase a Medicare Supplement Plan A, B, C, F, K, or L that is sold in your state by any insurance company. 

When:  No later than 63 calendar days from the date your coverage ends.

Guaranteed Issue Period for Medicare Supplement Plans:

8.  If you did not enroll in Medicare when you were first eligible (age 65) and you apply during the General Open Enrollment Period for original Medicare Part A and/or Part B, you have a six month Open Enrollment Period for enrollment into a Medicare Supplement Plan.

You can purchase a any Medicare Supplement Plan sold in your state by any insurance company.

When:  Within six months from the effective date of your original Medicare Part B.

It is Important To Know the Guaranteed Issue Periods for Medicare Supplement Plans

It is important that you pay attention to certain events in your life that may create a Guaranteed Issue Period which allows you to apply for a Medicare Supplement Plan without having to answer health questions, or qualify, for the plan.     Medicare Pathways reminds you that purchasing a Medicare Supplement plan, Medicare Advantage plan and/or a Prescription Drug Plan can assist with the out-of-pocket costs original Medicare leaves the Medicare beneficiary responsible for paying. Contact Medicare Pathways today and speak with a Benefit Advisor to discuss plan options and plan availability in your area and to determine if you are eligible to enroll into a Medicare insurance plan, or change the type of Medicare insurance plan you may currently have in force. Never assume you cannot change or you already have the most appropriate or most affordable coverage because plan and insurance carriers, as well as premiums, can change from year to year.  

 

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One thought on “Guaranteed Issue Periods for Medicare Supplement Plans

  • I was told you can not go up in a plan (A to F) in the open enrollment period because you are not in the guarantee period anymore or the Initial enrollment. That means staying with a Supplement plan and getting a better plan (A to F) can not be quarranteed. What is right?

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