Could a plan exit give you a right to buy Medigap without health underwriting?
In certain protected situations, federal Medicare rules provide guaranteed-issue rights for specific Medicare Supplement policies.
When can a plan exit create a Medigap right?
Under federal Medicare guidance, a person with Medicare Advantage may have a guaranteed-issue right if the plan leaves Medicare, stops providing care in the person's area, or certain other protected situations apply. This protection applies when the person switches to Original Medicare rather than enrolling in another Medicare Advantage plan.
What “guaranteed issue” means
In a protected situation, a Medigap insurance company must sell an eligible policy, must cover pre-existing conditions, and cannot charge more because of past or present health problems.
Not every plan letter is included
The federal Medicare guide lists certain Medigap plan letters for this situation. Eligibility also depends on when you first became eligible for Medicare, and state law may provide additional rights.
The application window is limited.
Medicare's Medigap guide says the federal application window for this type of protected situation can begin as early as 60 days before Medicare Advantage coverage ends and generally extends no more than 63 days after the coverage ends. The termination notice can also contain an important deadline.
What should you compare?
- Whether you prefer Original Medicare's provider access or another Medicare Advantage plan.
- The Medigap premium and the specific standardized plan letter available to you.
- A stand-alone Part D prescription drug plan if you return to Original Medicare and need drug coverage.
- Any additional rights available under New Jersey law.
Timing is important.
If a Medicare Advantage plan is ending, review the notice promptly so you do not miss an enrollment or guaranteed-issue deadline.
Request a Medicare reviewOfficial reference: Medicare's current Medigap guide describes federal guaranteed-issue protections and application deadlines. View the Medicare Medigap guide ↗