Medigap Guaranteed Issue

You may have a GUARANTEED RIGHT to buy a GA Medigap policy even if you are beyond your initial enrollment period. When you turned 65 and enrolled in Medicare you had 6 months to pick a Medicare supplement plan from any Georgia carrier and you did not have to answer health questions. GUARANTEED ISSUE rights are those you have when insurance companies are required by law to offer you specific Medigap policies regardless of your health and must cover any pre-existing conditions.   Medigap guaranteed issue rights in Georgia

Nancy’s Story

Nancy is a spry 83 year old widow that likes to lead an active life but will never miss an episode of Maury or TMZ. But after she fell a few times and could not remember to take her medication, her son knew it was time for her to leave South Carolina and come to live with him in Georgia.

Nancy had a Medicare Advantage plan with a $0 premium but also came with a lot of out of pocket expenses. When she fell and hurt her hip the doctors wanted her to spend a few days in the hospital until she was stable enough to be discharged to an intermediate care facility.

Her Medicare Advantage plan covered her stay but also left her owing almost $2,000 in copay’s and deductibles. When she moved to rural Georgia if she wanted to keep an Advantage plan there were few choices and even fewer doctors that participated in Medicare Advantage networks.

Her son and daughter-in-law were already clients of mine so they called and asked for my advice. Because Nancy was no longer in the service area of her prior plan she had a guaranteed issue right to purchase any Medicare supplement plan of her choosing.

Together we found a Medigap plan F that met her needs. Had it not been for her guaranteed right to purchase a plan Nancy would have had to enroll in an Advantage plan and drive 60 miles to the nearest participating doctor.

 

Medigap guaranteed issue

 Guaranteed Issue Medigap

Below are some of  your GUARANTEED ISSUE rights.

MEDICARE Initial Enrollment Period (IEP)

During your initial enrollment period you have a 7 month window of opportunity to purchase a Medicare supplement plan without providing evidence of insurability. Starting 3 months before your Medicare Part B effective date, the month your Part B is effective, and 3 months following your start date you can enroll in any Medicare supplement plan on a guaranteed issue basis.

MEDICARE Special Election Period (SEP)

You have a special election period for Part B if you are covered under an employer group plan through your job or your spouse’s work. This includes retiree coverage, COBRA or a union plan that continues beyond age 65.

MEDICARE Trial Enrollment Period

If you enrolled in a Medicare Advantage plan when you first became eligible for Medicare and within the first year of joining you decide to switch to original Medicare you may enroll in a Medicare supplement plan on a guaranteed issue basis. You have the same trial rights if you left Medicare and a Medigap plan to join an Advantage plan and want to switch back to original Medicare and a Medicare supplement plan during your first 12 months.

Disabled and Receiving Social Security Disability and Medicare

When you have been disabled under Social Security rules and have received Medicare for 24 months you can apply for a Medicare supplement plan on a guaranteed issue basis. This option is available to you even if you have not yet reaced age 65.

Leaving a Medicare Advantage Plan

If you have a Medicare Advantage plan and you move out of the service area you may enroll in original Medicare and a Medigap plan plan on a guaranteed issue basis. Similarly, if your Advantage plan withdraws from offering coverage in your area, or goes out of business, you may purchase a Medicare supplement plan without answering health questions.

Your Medigap Plan is Bankrupt

If you have original Medicare and your Medigap plan goes out of business and you lose your coverage you have a guaranteed right to purchase a new Medicare supplement plan without going through underwriting.

Your Advantage Coverage was Misrepresented

If your Medicare Advantage carrier or their representative misled you about your coverage or told you things about your plan that is not true, you may drop that plan and return to original Medicare and a Medicare supplement plan on a guaranteed issue basis.

You may encounter other situations where you can apply for a Medicare supplement plan in Georgia on a guaranteed issue basis but these are the primary reasons. Click to shop and compare GA Medigap quotes now.