Medigap Policies: Guaranteed Issue Periods & Their Timing?

Medigap Policies: Guaranteed Issue Periods & Their Timing?

There are some “Guaranteed Issue” periods that are assigned to Medicare supplemental policies. This allows people to request a policy without any denied insurance, irrespective of their pre- conditions, or to be charged more due to any health condition. Guarantee issue period (GI) rights are backed by federal mandates via the Centers for Medicare and Medicaid Services and is binding on all Medicare members who fall into the category of one of these particular situations.

In general, GI rights occur when the current health insurance is changed in a certain way or the insurance is in voluntarily lost. Some insurance companies can develop their GI situations,and sometimes they do. However, all Medicare supplement insurance firms must, in fact, follow seven GI situations prescribed by the Federation. You or any individual must be able to enroll in a Medicare supplement policy on a guaranteed issue basis if you are in one of these periods. These seven GI situations prescribed by the federal government are:

• You have enrolled in a MedicareAdvantage policy or policy when you become eligible to enroll and, within oneyear of enrollment, you decide to return to the original Medicare Supplementalpolicy. 

You enrolled in a Medicare Advantage policy and this policy stopped serving in your area, you leave the Medicare program, or you move out of the specific service area insured by the policy.

• You have union insurance or an employer that pays AFTER Medicare and this insurance will end soon. • Has a Medicare SELECT policy and istransferring from the service area insureed by the policy. You can keep thecurrent policy, but you have the right to change to a new policy based on GI.

• The Medicare Supplement company has failed and this results in the loss of insurance or, through your own fault, the insurance of the Medicare Supplement policy.

• A health care policy was left to switch to a Medicare Advantage or Medicare Advantage policy for the first time. The policy has been underway for less than a year and would like to return to Medigap policy.

• You have made the decision to subscribe to a Medicare Advantage policy or to abandon a Medigap policy because the provider has not followed the rules or cheated you in any way.

States also have the legal authorityto create additional GI situations, and some states have done so. Some of thespecific GI situations also have specific requirements for the policies towhich you can subscribe. For example, in the case of a complementary statehealth care policy, it is possible to qualify for an IM; however, it could beone of the recognized policies. If you are in Medicare, it is helpful to be aware of these situations of guaranteed problems. If you are eligible for one of them and choose not to enroll in a policy while that GI period is in effect, it is very likely that if you decide to enroll later, you must medically qualify for a Medicare Supplement.