Medicare Supplement policies are either “guarantee enrollment,” or they are “medically underwritten.”
If you are in a guarantee issue situation, you are not required to answer any health related questions, prescription or doctor information on the enrollment form. The enrollment is guaranteed regardless of your health status.
Medicare Supplement plans can be purchased if you have Medicare Parts A and B in place. From the moment you enroll in Part B, your Medicare Supplement “guaranteed issue” period, or open enrollment begins and can not be changed, and lasts for 6 months.
Part B is typically enrolled in when you become age 65 and or when eligible for Medicare. Examples are; when you turn 65 and have Medicare A and B, or if under age 65 and are disabled with Medicare. Another example is if you are still employed after age 65 and are leaving your employer health insurance plan. Please review the link above for all of the guaranteed-issue situations for a Medicare Supplement policy.
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Initial Enrollment Period … The most popular and most utilized guaranteed-issue situation is called the “Initial Enrollment Period,” which is when a person first enrolls in Medicare Part B coverage. This enrollment allows for a 6 month open-enrollment period for the new Medicare member to choose any and enroll in a new Medicare Supplement policy of their choice .. Guaranteed. No pre-existing condition waiting periods and no medical history review. When the policy starts your coverage starts as well without any waiting periods.
During guarantee-issue situations, insurance companies are not allowed to use medical underwriting as an enrollment acceptance tool. This is great news for anyone desiring to enroll in a Medicare Supplement plan. In these cases, insurance companies are required by law to sell you a Medigap policy, despite any pre-existing conditions, and they cannot charge you more because of those conditions. If you are interested in purchasing a Medigap policy, this is the one of the best time to enroll.
Medicare Advantage … People who join a Medicare Advantage health plan like an HMO or PPO plan, may also have Medicare Supplement guaranteed issue rights if their plan terminates, if they leave the plan service area or if they want to return to a Medigap plan within 12 months of first having a Medicare Advantage plan.
There are additional circumstances that may qualify you for guaranteed-issue rights to a Medicare Supplement plan, and some states have stronger protections, including for people with Medicare who are under 65.
If you are turning 65 or coming off of an employer health insurance plan you can usually apply for an open enrollment guaranteed-issue Medicare Supplement policy as early as 60 days before your current benefits end to avoid a gap in coverage.
Please remember, open enrollment has a six month window to apply for coverage. If you are coming off of an employer plan, in most cases, you must apply for a plan no later than 63 days after your coverage ends. When you submit your application, you are typically required to provide evidence of the date your employer coverage ends or ended.
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