How Medigap Guaranteed Issue Rights work

By Mei Horstman


Medigap Guaranteed Issue Rights allow enrollment in a Medicare Supplement plan even outside of the Open Enrollment Period, without a increase in premiums and does not take into consideration of pre-existing conditions.

Guaranteed issue rights, usually known as "Medigap Protections", defend those who are losing their Medicare coverage. A individual maybe losing their group health insurance policy due to the end of a marriage or the death of a spouse or family member, or the end of an employer sponsored healthcare plan.

Conditionally, Medigap guaranteed issue rights provide that you can still enroll in a Medicare Supplement plan away from your Open Enrollment Period. These rights are guaranteed, that a beneficiary cannot be billed at a higher monthly premium because of existing health issues, and that all pre-existing conditions must be honored if current coverage is terminated.

Medigap guaranteed issue rights protect you in the following provisions: Your existing Medicare-backed plan, Medicare Advantage, PACE, etc., is moving from Medicare or becomes unavailable in your area. Your employer-sponsored retiree plan that pays after Medicare pays is finished. You have Original Medicare and a Medicare Select policy and you move from the plan's coverage region. You joined Medicare Advantage plan when you became first eligible and, during the first year of joining, you want to make the switch to Original Medicare Part A and Part B. You finished a previous Medicare Supplement Insurance policy to join a Medicare Advantage plan for the very first time; you have been in the plan during the first year, and you would like to go back to the previous plan. Your Medicare Supplement Insurance provider ceases to exist, resulting in no coverage, or your Medigap policy coverage otherwise terminates through no fault of your own. You leave a Medicare Advantage plan or drop a Medigap policy because the company either misinformed you or bent the rules.

Therfore Medicare Supplement is an added benefit to Original Medicare, guaranteed issue rights only apply to those seeking Medigap coverage to go with Medicare Parts A and B. We plan on covering more Medicare Supplement Insurance topics on the Ask Medicare blog, including an introduction, a series on the cost of Medigap plans and the differences of Medicare Supplement Insurance vs. Medicare Advantage plans.

The Ask Medicare blog has a bundle of information on Medigap guaranteed issue rights, including the descriptions of each plan and its availability.




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