Medigap guaranteed issue rights
Guaranteed issue rights in Florida and nationwide
Guaranteed Issue Rights (Also Called "Medigap Protections") are rights you have in certain situations when insurance companies in Florida must offer you certain Medigap policies. In these situations, an insurance company:- Must sell you a Medigap policy
- Must cover all your pre-existing health conditions
- Can't charge you more for a Medigap policy because of past or present health problems
In most cases, you have a guaranteed issue right when you have other health coverage that changes in some way, like when you lose the other health coverage. In other cases, you have a "trial right" to try a Medicare Advantage Plan (Part C) and still buy a Medigap policy if you change your mind.
Uses medical underwriting which is The process that an insurance company uses to decide, based on your medical history, whether to take your application for Medigap insurance, whether to add a waiting period for pre-existing conditions (if your state law allows it), and how much to charge you for that insurance, or applies a different premium when you don’t have a guaranteed issue right (also called “Medigap protections”), or aren’t in a Medigap Open Enrollment Period which is A one-time only, 6-month period when federal law allows you to buy any Medigap policy you want that's sold in Florida. It starts in the first month that you're covered under Part B and you're age 65 or older in Florida. During this period, you can't be denied a Medigap policy or charged more due to past or present health problems. Some states may have additional open enrollment rights under state law.
You have a guaranteed issue right (which means an insurance company can’t refuse to sell you a Medigap policy) in these situations:
Medigap Plan A,B,C*,D*,F*,G*,K, or L that's sold by any insurance company in your state.
| Note |
| Plans C and F will no longer be available to people who are new to Medicare on or after January 1, 2020. However, if you were eligible for Medicare before January 1, 2020 but not yet enrolled, you may be able to buy Plan C or Plan F. People eligible for Medicare on or after January 1, 2020 have the right to buy Plans D and G instead of Plans C and F. |
You only have this right if you switch to Original Medicare rather than joining another Medicare Advantage Plan.
You can/must apply for Medigap policy:- As early as 60 days before the date your coverage will end
- No later than 63 calandar days after your coverage ends
Medigap Plan A, B, C*, D*, F*, G*, K, or L that’s sold by any insurance company in your state.
| Note |
| Plans C and F will no longer be available to people who are new to Medicare on or after January 1, 2020. However, if you were eligible for Medicare before January 1, 2020 but not yet enrolled, you may be able to buy Plan C or Plan F. People eligible for Medicare on or after January 1, 2020 have the right to buy Plans D and G instead of Plans C and F. |
If you have COBRA coverage, you can either buy a Medigap policy right away or wait until the COBRA coverage ends.
You can/must apply for a Medigap policy no later than 63 calendar days after the latest of these 3 dates:- Date the coverage ends
- Date on the notice you get telling you that coverage is ending (if you get one)
- Date on the claim denial, if this is the only way you know that your coverage ended
| Note:
Your rights may last for an extra 12 months under certain circumstances. |
Medigap Plan A, B, C*, D*, F*, G*, K, or L that’s sold by any insurance company in your state.
| Note |
| Plans C and F will no longer be available to people who are new to Medicare on or after January 1, 2020. However, if you were eligible for Medicare before January 1, 2020 but not yet enrolled, you may be able to buy Plan C or Plan F. People eligible for Medicare on or after January 1, 2020 have the right to buy Plans D and G instead of Plans C and F. |
You can/must apply for a Medigap policy:
- As early as 60 calandar days before the date your coverage will end
- No later than 63 calandar days after your coverage ends
You can/must apply for a Medigap policy:
- As early as 60 calandar days before the date your coverage will end
- No later than 63 calandar days after your coverage ends
| Note:
Your rights may last for an extra 12 months under certain circumstances. |
The Medigap policy you had before you joined the Medicare Advantage Plan or Medicare SELECT policy, if the same insurance company you had before still sells it.
If your former Medigap policy isn't available, you can buy a Medigap Plan A, B, C*, D*, F*, G*, K, or L that’s sold by any insurance company in your state.
| Note |
| Plans C and F will no longer be available to people who are new to Medicare on or after January 1, 2020. However, if you were eligible for Medicare before January 1, 2020 but not yet enrolled, you may be able to buy Plan C or Plan F. People eligible for Medicare on or after January 1, 2020 have the right to buy Plans D and G instead of Plans C and F. |
You can/must apply for a Medigap policy:
- As early as 60 calandar days before the date your coverage will end
- No later than 63 calandar days after your coverage ends
| Note:
Your rights may last for an extra 12 months under certain circumstances. |
Medigap Plan A, B, C*, D*, F*, G*, K, or L that’s sold by any insurance company in your state.
| Note |
| Plans C and F will no longer be available to people who are new to Medicare on or after January 1, 2020. However, if you were eligible for Medicare before January 1, 2020 but not yet enrolled, you may be able to buy Plan C or Plan F. People eligible for Medicare on or after January 1, 2020 have the right to buy Plans D and G instead of Plans C and F. |
You can/must apply for a Medigap policy:
- No later than 63 calandar days from the date your coverage ends
Medigap Plan A, B, C*, D*, F*, G*, K, or L that’s sold by any insurance company in your state.
| Note |
| Plans C and F will no longer be available to people who are new to Medicare on or after January 1, 2020. However, if you were eligible for Medicare before January 1, 2020 but not yet enrolled, you may be able to buy Plan C or Plan F. People eligible for Medicare on or after January 1, 2020 have the right to buy Plans D and G instead of Plans C and F. |
You can/must apply for a Medigap policy:
No later than 63 calandar days from the date your coverage ends| Note |
| There may be times when more than one of the situations above applies to you. When this happens, you can choose the guaranteed issue right that gives you the best choice. |
Can I buy a Medigap policy if I lose my health coverage?
You may have a guaranteed issue right to buy a Medigap policy. Make sure you keep these items:
- A copy of any letters, notices, emails, and/or claim denials that have your name on them as proof of your coverage being terminated
- The postmarked envelope these papers come in as proof of when it was mailed
You may need to send a copy of some or all of these papers with your Medigap application to prove you have a guaranteed issue right.
If you have a Medicare Advantage Plan but you’re planning to return to Original Medicare, you can apply for a Medigap policy before your coverage ends.
The Medigap insurer can sell it to you as long as you’re leaving the plan. Ask that the new policy take effect no later than when your Medicare Advantage enrollment ends, so you’ll have continuous coverage.
| Note |
| The guaranteed issue rights in this section are from federal law. These rights are for both Medigap and Medicare SELECT policies. Many states provide additional Medigap rights. |