Beneficiaries may be charged more to purchase Medigap after their IEP.

In many cases, insurance companies are allowed to medically underwrite Medicare Supplement Insurance policies if you apply for coverage after your initial enrollment period. This means they can take your current health status into account when determining your eligibility for coverage and the cost of your premiums. However, whether they choose to medically underwrite and the specific rules vary by state and may change over time.

Here's a general overview of how medical underwriting for Medigap policies works:

1. Initial Enrollment Period (IEP): During your Medigap Initial Enrollment Period, which begins when you're both 65 or older and enrolled in Medicare Part B, insurance companies typically must sell you any Medigap policy they offer, and they cannot consider your health status. This is the best time to buy a Medigap policy because you have guaranteed issue rights.

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2. Medically Underwritten Medigap Policies: If you apply for a Medigap policy outside of your IEP, insurance companies in many states have the option to medically underwrite your application. This means they can assess your current health condition and may:
• Charge you higher premiums based on your health status.
• Deny coverage based on pre-existing conditions.
• Impose waiting periods for coverage of pre-existing conditions.

3. State Regulations: Some states have additional consumer protections, such as continuous open enrollment periods or limits on medical underwriting. In these states, insurance companies may have more restricted abilities to medically underwrite Medigap policies.

4. Guaranteed Issue Rights: There are situations in which you have guaranteed issue rights, even outside of your IEP, where insurance companies cannot medically underwrite your application. These include situations like losing other health coverage, your Medigap policy leaving the market, or other specific circumstances outlined in federal law.