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Guaranteed Issue Rights

June 11, 2017

 

Guaranteed issue rights (also called "Medigap protections") are rights that a person has in certain situations when insurance companies must offer them certain Medicare Supplement policies. 

 

The following 8 situations may provide a Medicare beneficiary with a Medicare Supplement guaranteed issue right that allows them to purchase a Medicare Supplement policy after their Medicare Supplement open enrollment period ends.

 

An insurance company cannot refuse to sell them a Medicare Supplement policy in the following situations:

  1. They have a Medicare Advantage plan and it is leaving Medicare or ending coverage in their area.

  2. They have a Medicare Advantage plan and they are moving out of the plan’s service area.

  3. They have Medicare Parts A and B (Original Medicare) and they need to replace an employer health plan that will soon be discontinued.

  4. They have Original Medicare and a Medicare SELECT policy and they move out of the policy’s service area.

  5. They joined a Medicare Advantage plan or PACE when they were first eligible for Medicare Part A at 65 & within the first year of joining they want to switch to Original Medicare.

  6. They dropped a Medicare Supplement policy to join a Medicare Advantage plan for the first time and within the first year of joining they want to switch back to Medicare Supplement.

  7. Their Medicare Supplement insurance company goes bankrupt or ends their policy through no fault of their own.

  8. They leave a Medicare Advantage plan or Medicare Supplement policy because the company misled them or did not follow the rules

     

     

     

     

     

     

     

     

     

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June 11, 2017

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This website is a private website and is not associated, endorsed or authorized by the Center for Medicare and Medicaid Services, nor do we claim to be. This site contains basic information about Medicare Supplement insurance for people with Medicare. If you would like to find more information about the Medigap program, please visit the Official US Government Site located at www.medicare.gov.