Is Guaranteed Issue available after the Medicare Open Enrollment period ends?
Answered by 10 licensed agents
Guaranteed Issue is available for up to 6 months after your Part B becomes effective, and it doesn't have to coincide with with the Medicare Open Enrollment Period. There are also other situations in which Guaranteed Issue applies, but consult with a local independent health broker to determine if your situation applies.
I suggest you go to Medicare.gov and put in the search box "SEP's". This stands for Special Election periods. These represent "odd" times when certain circumstances occur which allow you to use an SEP and change your initial plan. There are numerous SEP's that folks can utilize at their discretion. The most obvious one is when you have moved your domicile to another location be it within your State OR outside your current State.
Most of the time however, "GI" or guaranteed issue are for those newly eligible Medicare folks who are within that 7-months' window of eligibility. That is: 3 months before your birthday month, your actual birthday month and 3 months after your birthday month for a grand total of 7 months.
However, folks are usually not aware of what is called a "trial right". This means that if they are inside one year of having joined Medicare at age 65, they can exercise a trial right, dropping what they initially thought was better, in favor of an alternate plan (whether it is a free Advantage or a monthly Medigap (or Med. Supplement) premium plan).
No, the Guaranteed Issue rights for Medigap plans do not necessarily end with Open Enrollment ending. Medigap Open Enrollment period last for six months starting first day of the birthday month age 65 or older and enrolled in Part B.
Yes, if you fall into one of the SEP's, the Special Enrollment Periods. If you change your residence to outside of the service area, you move from another state, you lose coverage through no fault of your own, you leave your Employer Group Health insurance plan are a few examples.
Once a person is past their Medicare open enrollment for a Medicare supplement, guaranteed issue is no longer available. The only exception to this is if they were enrolled in an Advantage plan and the carrier pulled the plan from the market. At that point the beneficiary has a guaranteed issue to go back to Original Medicare and enroll in a supplement.
If a beneficiary decides to enroll in an Advantage plan, those plans are guaranteed issue during Annual Enrollment Period Oct 15-Dec 7 each year for a January 1 effective date.
Guaranteed issue into a Medicare Supplement is available for 1 year. When you turn 65 it begins and it ends the day before you turn 66. You can enroll 3 months ahead of time, your plan is effective the 1st of the month of your birthday.
In some situations you may still be able to purchase a medigap policy. Under guaranteed issue rights, a company is required to sell you a Medigap policy at the best rates.
Yes guaranteed issue rights are available after Open Enrollment, but are limited to specific circumstances. Guaranteed issue means 1) no denial based on health status, 2) no medical underwriting, 3) no rate increase. Please discuss your circumstances with a licensed agent.