Medicare Supplement Insurance, or Medigap, is a valuable resource to help cover healthcare costs that Original Medicare doesn’t. Understanding when Medigap insurance providers can deny coverage and when they are obligated to offer you a policy is crucial.
Medigap Open Enrollment Period = Cannot be Denied
Most people enroll in a Medigap plan during the initial Open Enrollment Period (OEP). This initial period begins when you sign up for Medicare Part B and are at least 65 years old. During these six months, Medigap insurance companies cannot deny you coverage due to pre-existing health issues.
This means you have a guaranteed window to enroll in the Medigap plan of your choice without worrying about your medical history.
Medigap Guaranteed Issued= Cannot Be Denied
In addition to the Open Enrollment Period, there is a provision known as “guaranteed issue.” This guarantee varies by state and may offer additional protection against coverage denial in certain situations such as moving to a new state. Under guaranteed issue, Medigap companies must offer you a policy even outside the Open Enrollment Period, and they cannot deny you coverage based on pre-existing conditions. Click here to learn more about guaranteed issue situations.
State Specific Laws = Cannot Be Denied Medigap
Many states have added laws to protect their citizens from being turned down for Medicare Supplemental insurance. A good example would be New York which passed a law to allow all Medicare-eligible individuals to be approved for Medigap no matter when they apply. You can view a complete list of State-Specific guaranteed issued Medigap rules here.
When Can They Deny Medigap?
Insurance providers can decline your Medigap application if you apply outside of OEP and have no guaranteed issued protections mentioned above. So, a good rule of thumb is, if you have had Medicare Part B for more than 6 months (and you don’t have any Medigap guarantee issue protections) you could be declined for Medigap. In most states there is no annual open enrollment period to sign up for Medigap without being denied.
The answer to this article’s question is yes then can decline your Medigap if you apply outside your OEP window. Check our Medicare Deadline Calculator to make sure you don’t miss your enrollment window (you can even sign up for reminders!)
Why Enroll in Medigap at all?
Overall, Medigap is designed to provide peace of mind by covering costs that Original Medicare excludes. It’s crucial to take advantage of your Open Enrollment Period and understand the guaranteed issue rules in your state to ensure you get the coverage you need without worrying about denial due to pre-existing conditions. If you have questions about Medigap or need personalized guidance, it’s always advisable to speak with our licensed Medigap agents at Senior65.com, who can help you navigate the available options. Your health and well-being are paramount!
For personalized assistance and to explore Medigap plans tailored to your needs, contact one of our licensed agents at 800-930-7956. Don’t wait; secure your healthcare coverage today!