Guaranteed Issue Rights & Medigap Plans

Have you been denied a Medicare Supplement Plan? Did you miss your IEP?  Well, if you have guaranteed issue right, you may be able to still access the best rates!


What is a Medicare Supplement Plan?

Original Medicare consists of Medicare Part A and Part B.  Part A is your hospital insurance.  Part B is your outpatient insurance. Although Original Medicare provides excellent coverage, there are definitely some gaps.

Additionally, there is no out of pocket max with Original Medicare. Although Medicare usually covers about 80% of the costs, that 20% that you’re left with can really add up. So, Medicare Supplement Plans (also known as Medigap Plans) are designed to limit your out of pocket costs and cover the gaps of Original Medicare.

There are many different plans to choose from. Although they are offered by private carriers at different prices, they are standardized. So, the benefits are the same regardless of the carrier. Remember, if your doctor accepts Medicare, they accept your Medicare Supplement Plan, regardless of your insurance company. You just need to choose a carrier with a history or low, stable rate increases. Prices do tend to go up on a yearly basis to accommodate for inflation and rising healthcare costs.


Individual Enrollment Period

The easiest way to ensure all of your options are open is to enroll during your individual open enrollment period. Although you can enroll in a supplement plan year round, it’s only during this time that you can enroll without any medical underwriting. Should you have to undergo medical underwriting, your carrier can choose to charge you more or deny you outright!

So, when is your Individual Enrollment Period? Well, with Medicare Supplement Plans, it is the six month period after you turn 65 and enroll in Medicare Part B. If you are still working past 65, you may choose to defer Medicare Part B in favor of your employer sponsored group health insurance. In that case, you would need to follow the instructions on the back of the card and send it back! If you keep the card, you keep Medicare Part B. Not only will you be charged for it, but you may end up missing your IEP.

Once you’ve decided to enroll in a supplement plan you can logon on Medicare.gov or contact a broker to discuss your options.


Guaranteed Issue

If you miss your IEP, you can also buy a Medigap when you have a guaranteed issue right. If you are age 65 or older, you have a guaranteed issue right within 63 days of when you lose or end certain kinds of health coverage.

When you have a guaranteed issue right, companies must sell you a Medigap policy at the best available rate.  You cannot be charged more or denied based on your health status. The best available rate may depend on a series of factors.  Medicare.gov can give you a range of prices for a given plan, but you will need to contact the carrier for your specific rate.

You may have guaranteed issue right if:

  • You Are Within the Medicare Advantage Trial Right Period
  • Your Medicare Advantage Plan or Medigap Plan goes Bankrupt
  • Your Medicare Advantage Plan Leaves the Area (or You Do)
  • You Were Misled by Your Medicare Advantage Plan or Medigap Plan

Make sure to hold onto any paperwork you may receive to ensure a smooth enrollment process.

If you have any questions, you can reach us at iHealthBrokers at 888-918-0518 or schedule a call today!


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Jesse Smedley is the Principal Broker for iHealthBrokers and the founder, president, and CEO of Smedley Insurance Group, Inc. and iHealthBrokers.com. Since the inception of SIG in 2007, Jesse has been dedicated to helping people save money on their health insurance by providing them with resources to educate themselves on all their health insurance options, both under age 65 and Medicare beneficiaries. He is featured in many publications as well as writes regularly for expert columns regarding health insurance and Medicare.

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