What is Guaranteed Issue for Medicare Supplement plans, and when does it apply?
Answered by 10 licensed agents
Guaranteed issues for Medicare supplement plans ensure you can purchase a Medicare supplement/Medigap plan that picks up the gaps that Medicare Part A and B leave behind. A guaranteed issue means you do not have to be questioned about your health conditions with the insurance underwriters, and the policy will not be denied. Guaranteed issue applies to the six months around your 65th birthday. Three months before your 65th birthday, the month of your 65th birthday, and three months after your 65th birthday, you have the right to get a guaranteed issue policy for your Medigap plans. After that, there are some special guarantee issues when retiring from a group insurance plan, but that would be for another discussion.
When clients ask about Guaranteed Issue for Medicare Supplement plans, I explain it’s a right that stops insurers from denying coverage or raising rates due to pre-existing conditions. It applies during your initial enrollment at 65—starting the first day of your birthday month and lasting six months—or within 63 days of losing qualifying coverage, like an employer plan, or during your 12-month trial period if you’re new to Medicare Advantage and switch back to Original Medicare. For folks under 65 with disabilities, federal law doesn’t guarantee it, but many states offer a similar six-month window when you enroll in Part B. Missing these windows usually means facing medical underwriting.
You do not have to answer health questions during your initial enrollment (turning age 65 or loss of group coverage over age 65) If you ever want to switch from addvantage to a supplement you have to be healthy
You are always a "GI" or a guaranteed issue person when you first become eligible for Medicare, usually at age 65 (you have a 7-month window to apply; 3 months before your birthday month; your actual birthday month and then 3 months after your birthday month for a grand total of 7 months). If an entire year elapses and you're now 66 years old, if you wanted to possibly change your 1st plan to another company's Supplement, you would have to go thru Underwriting to verify that you have NO pre-existing health conditions.
Guaranteed issue period for Medicare supplement is 3 months prior to the month you turn 65, the month you turn 65 an d 3 months after the month you turn 65 got a total of 7 months. During this time frame you do not have to answer any health questions and are guaranteed acceptance at preferred rates
Guarantee Issue for Medicare Supplement Insurance plans, also called Medigap Insurance, is when an Insurance Company cannot underwrite the proposed insured, the applicant. The proposed insured does not need to provide evidence of insurability to the Insurance Company and cannot be denied as long as they are eligible for the Policy & pay the initial premium.
It applies at certain times. Six months before & six months after the 65th birth month of the applicant. Thank you.
Guaranteed issue is a time period where you cannot be denied coverage for a Medicare supplement plan due to illnesses. There's a number of special periods that this can occur and it varies by state. If you'd like to have a conversation to fully understand your situation and how this works for you, please feel free to contact me.
When you turn 65 and apply for Medicare part B, you have 6 months from the part B effective date to apply for Medicare Supplement . Within this 6 month period your acceptance is guaranteed. Past 6 months you are subject to underwriting process.
Guaranteed Issue Rights apply when you lose your current health benefits - for a number of reasons (for example: Your spouse is still working beyond age 65 and has you on their plan. You have Medicare but missed your "Open Enrollment." You've been using your Medicare to pay deductibles, coinsurance and co-pays you would otherwise pay out-of-pocket. Two years later she decides to retire and you lose spousal coverage under her employer health care benefit.)
Once you qualify for "Guaranteed Issue," you are not required to go through medical underwriting.
