Medicare Supplement plans include specified “Guaranteed Issue” periods that enable people to apply for a plan without being denied coverage, having their pre-existing conditions excluded, or being charged extra because of any health issues that they may be suffering from.
All Medicare participants who fall into one of these specified categories are entitled to guaranteed issue (GI) rights, which are required by the Centers for Medicare & Medicaid Services in the United States.
The GI rights are often invoked when your existing health care coverage is altered in a certain manner or when you are unintentionally dropped from your present coverage. While certain insurance companies have the ability to establish their own GI scenarios, and many do, there are seven federally regulated GI situations that all Medicare Supplement insurance companies must adhere to in order to be considered compliant. As long as you fall within one of these time frames, you should be eligible to enroll in a Medicare Supplement plan under the Guaranteed Issue program.
The Following Are The Seven Scenarios
In the event that you have employer or union coverage that pays AFTER Medicare, you will lose that coverage.
Your Medicare Advantage plan is terminating its participation in the Medicare program, ceasing to serve your region, or you are relocating out of the plan’s specified service area, and you need to know what to do.
A Medicare Select insurance covers you, and you are relocating out of the plan’s coverage region. What should you do? You have the option to maintain your existing insurance, but you also have the option to move to a new coverage on a GI basis.
If your Medicare Supplement Plans agency goes bankrupt, you will be unable to continue receiving benefits. Alternatively, you may find yourself without Medicare Supplement plan coverage due to no fault of your own.
The Medicare Advantage plan or PACE that you chose when you were initially eligible to enroll has expired and you desire to move from that plan or PACE to “classic” Medicare within a year after enrolling (and a Medicare Supplement plan).
You decided to forego a Medicare Supplement Plans in order to enroll in a Medicare Advantage or Medicare SELECT coverage for the first time, which was a good decision. You have been enrolled in that plan for less than a year and would want to return to Medigap coverage.
A Medigap insurance or Medicare Advantage plan is terminated because the company has failed to follow the regulations or has deceived you in some manner, and the reason for the termination is given.
In addition, individual states have the right to establish other GI scenarios, and several have done so in the past. In addition, some of the unique GI scenarios have certain limitations for the plans that you may enter into as well. For example, you may be qualified for a guaranteed enrollment into a Medicare Supplement plan; but, you may only be able to enroll in one of a few specific plans.
To Conclude
If you are a Medicare beneficiary, it is in your best interest to be aware of these assured issue scenarios. You will very certainly be required to meet medical requirements for a Medicare Supplement plan if you fall into one of these categories and choose not to enroll in a plan during the GI period that is in place at the time of your enrollment decision. If you are in the market for some medical insurance, you may visit here for the best offer.
