What does it mean to get Medigap with guaranteed issue? And when does this come into play?
Here is one example:
Medicare says that when people are required to change their Medicare Advantage plan because of a move, they can apply for a Medicare supplement and not have to worry about the medical questions. They cannot be rejected, or charged a higher premium because of serious health problems. This is called getting medigap with guaranteed issue.
I’ve recently received calls from people moving to Tucson who had a Medicare Advantage plan in another state. I explained their two options for their Medicare coverage when they move to Tucson.
1) They could enroll in a Medicare Advantage plan in Tucson. But they must find a primary care physician (PCP) whose name must be put on the Advantage plan application. This is because just about all of the Medicare Advantage plans in Tucson are HMOs and require PCPs to get referrals to see specialists.
2) They can enroll in a Medicare supplement and a stand-alone Part D plan. They cannot be refused the Medicare supplement or be charged a higher premium than is standard for their age. This is called getting Medigap with guaranteed issue.
When the Medigap application is submitted, they must already have a cancellation letter from their Medicare Advantage plan, so they should get moving early in the month before they need their new coverage to begin.
Getting Medigap with guaranteed issue can be a money saver.
For some people, their Medicare Advantage cancellation will turn out to be a very good thing because they can go back to Original Medicare and get Medicare supplement with guaranteed issue. Without guaranteed issue, these folks might not be able to get a Medicare supplement. So they have a one-time opportunity to make a major change to their Medicare coverage.
NOTE: Some states have rules that require insurance companies to “guarantee issue” for Medicare supplements no matter how old a person is, or what their health situation is. I know California and Connecticut have such rules. But Arizona allows insurance companies to reject people who apply for a Medigap plan outside their initial enrollment period when they turn 65 or first get Medicare Part B.
This video explains your Medicare choices and the difference between Medicare Advantage and Medigap/Medicare supplements.