Guaranteed issue rights and Medigap protections

Insurance companies participating in the Medicare program are required by law to offer you a Medigap policy (a supplemental Medicare policy) with "guaranteed issue rights" and Medigap protections. In your Initial Enrollment Period (IEP), an insurance company cannot deny you a Medigap policy, impose conditions on a Medigap policy, such as exclusions for pre-existing conditions, or charge you more for a Medicare Supplement Insurance due to a past or present health problem.

Under certain circumstances, individuals have guaranteed issue rights, which means that insurance companies cannot deny them coverage or charge them higher premiums due to pre-existing conditions. The following are some examples of situations where an individual may have guaranteed issue rights for Medigap coverage:

• If an individual loses their existing health coverage due to certain situations, such as the termination of an employer-sponsored health plan, they have a 63-day window to enroll in a Medigap policy without being denied coverage or charged higher premiums.
• If an individual's Medicare Advantage plan is discontinued or they move out of the plan's service area, the beneficiary has a 63-day window to enroll in either Original Medicare and/or a Medigap policy or another Medicare Advantage plan.
• If an individual has a Medigap or Supplement policy but wants to switch to a different Medigap or Supplement policy with the same or fewer benefits, they may have a 63-day window to do so without being denied coverage or charged higher premiums.