How likely am I to qualify for Medigap at 73 after the six-month enrollment period? I have some medical history and a possible cancer workup, but no diagnosis, hospitalizations, or treatment.

Question

Brian Penner · Accepted Answer

This comes up a lot, and the honest answer is: it depends on your state and on timing more than on your age. Outside your six-month Medigap Open Enrollment window, most states let carriers ask health questions, and they can approve, rate you up, or decline.

Here's the part that matters in your situation: Medigap applications don't just ask about diagnoses — they ask about pending tests, recommended treatment, and symptoms under investigation. A "possible cancer workup" with no diagnosis usually isn't a decline for being sick; it's a postpone for being unresolved. Most carriers won't approve while a workup is open, because they can't underwrite an unknown. Once the workup closes with a clean result, your odds improve dramatically — no hospitalizations, no diagnosis, and no treatment history is actually a decent underwriting profile at 73.

So the practical path is usually: (1) let the workup resolve first, (2) answer every application question truthfully — a misstatement can void the policy later, and (3) check your state's rules before assuming you'll be underwritten at all. A handful of states have birthday rules or year-round guaranteed-issue windows, and there are federal guaranteed-issue situations (like losing certain coverage) where health questions can't be asked. An independent agent who works with several Medigap carriers can pre-screen you against each carrier's health questions before you ever submit an application, so a decline never hits your record.

Ann Sanfelippo · Answer

Once your six-month Medigap Open Enrollment Period has ended, most insurance companies can use medical underwriting to decide whether to accept your application. Having no cancer diagnosis, hospitalizations, or treatment may work in your favor, but an ongoing cancer evaluation or other medical history could still affect your eligibility, depending on the insurer's underwriting guidelines. Every company evaluates health conditions differently, so the outcome can vary.

Answered by Ann Sanfelippo on July 28, 2026

Broker Licensed in FL, AL, AZ & 14 other states

Answered by Ann Sanfelippo Medicare Insurance Agent

Steve and Sue Brauer · Answer

Hi, my name is Steve and I'm the husband half of the Medicare husband and wife team here in Arizona and California. Sue's off today.

The question we have today is someone's asking, they said they're 73 years old. It could be any age actually. But they're asking if they have a chance to get a Medigap plan, sometimes they call it a Medicare supplement plan, if they're doing a cancer workup and they've had some hospitalization and that kind of thing. We get that question a lot too.

Here's the deal on that. Once you're out of your one year period for being on a Medicare Advantage plan, typically you have to go through underwriting if you want to move to a Medigap supplement plan. There's some nuances to that though.

If you move out of the service area of your Medicare Advantage plan, that opens up a window for you to get Medicare and enroll in a Medigap plan with no underwriting. That's here in Arizona and California.

If you're in California, they have what's called the birthday rule. So once a year during your birth month, you have the ability to go to a Medigap plan. That's a whole nother conversation, but California is like one of the only ones that does that.

Here in Arizona, if you move out of the service area, and there's a few other ones that I can't remember right now, but there are some ways to get a Medigap plan.

Typically when you go through underwriting, the questions they ask are things like, have you been in the hospital in the last 90 days? Do you have any of the following conditions? And they're pretty serious conditions, because they know people 65 plus, I mean, I'm over 65, they know that people have issues. They ask things like, do you take any of the following medications? And they have probably 20 or 25 different medications, because they'll never tell you this, but they're looking for people that they're not going to have to spend a lot of money on. I mean, that's the bottom line. It's a business. They want to insure somewhat healthy people. So that's what they're looking for.

So every situation is different, but underwriting is not super strict.

Jeremy Laurin · Answer

There is a chance you could qualify, and it's worth trying if that's your desire. However, I would caution that the potential cancer diagnosis could make things difficult. Once you are past your initial enrollment period at 65, you would have to answer a variety of health questions. Each carrier has different questions, so if you were to attempt this with me, I would see which ones you'd be most likely to actually qualify for.

Answered by Jeremy Laurin on July 28, 2026

Broker Licensed in PA

Answered by Jeremy Laurin Medicare Insurance Agent

Mike Fields · Answer

It is always possible to get a quote with another Medigap plan to see if you can qualify and if so, what the cost would be. These quotes have no impact, and many times people pass the underwriting even with some medical history. In addition, we have found special programs the past two years where a specific company will offer anyone on another Medigap Guaranteed Acceptance. This has been very popular with some of my clients that have serious health issues, and their current plan has raised prices significantly, but they would not be eligible to underwriting.

Answered by Mike Fields on July 28, 2026

Agent Licensed in SC, CO, GA, IN & NC

Answered by Mike Fields Medicare Insurance Agent

Gary Suell · Answer

Insurance carriers have different qualifications. You will have to qualify for the Medigap plan based on the carrier. Each carrier has its own underwriting criteria. They may have a look-back period from which you must have had certain diagnoses or procedures or illnesses. Most require that you do not have pending tests or procedures or tests for which you do not have results.

Answered by Gary Suell on July 27, 2026

Broker Licensed in TX, FL & GA

Answered by Gary Suell Medicare Insurance Agent

Andrew Zurbuch, MBA · Answer

That is a difficult to know for certain. However, a good chance if you work with a Broker whom represents several insurance companies. A Broker with a expert knowledge of Medigap insurance. It depends on the underwriting criteria of the insurance company whom you apply with & your health when you apply. The underwriting is different between the insurance companies. Thank you.

Answered by Andrew Zurbuch, MBA on July 28, 2026

Broker Licensed in IN, FL, KY, MO, OH & TN

Answered by Andrew Zurbuch, MBA Medicare Insurance Agent

Mark Michael · Answer

If you have a change of residence out of network for your current coverage, or have your current coverage sent you notice they have an area reduction and no longer Carry your plan. 
Could be are that your plan has raised a specific more then 15% ( this one is recently being reconsidered).

How likely am I to qualify for Medigap at 73 after the six-month enrollment period? I have some medical history and a possible cancer workup, but no diagnosis, hospitalizations, or treatment.

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How likely am I to qualify for Medigap at 73 after the six-month enrollment period? I have some medical history and a possible cancer workup, but no diagnosis, hospitalizations, or treatment.

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