Guaranteed issue rights (also called “Medigap protections”) are exceptions granted to Medigap applicants under certain circumstances. For instance, those new to Medicare or losing their current coverage may qualify for a guaranteed issue right. In these situations, an insurance company:
- Must sell a Medigap policy to an applicant
- Must cover all pre-existing health conditions
- Can’t charge more for a Medigap policy because of past or present health problems
State Specific Medigap Enrollment Periods
New York + Connecticut (Year Round OE)
Any plan, any carrier, any time. The client does not have to be on a Medicare suppliment for the rule to apply.
California + Oregon (Annual Birthday)
Must apply within 30 days before to 30 days after Birthday. Coverage cannot start until after the birthday.
Maine (Annual OE)
Can switch carriers or plan with equal or lesser benefits. Current Medigap must be in force for at least 90 days.
Missouri (Annual OE)
Must apply within 30 days prior or 30 days after the policy anniversary date. Can go to the same plan only.
Vermont (Year-Round OE for Certain Carriers)
Only for Mutual of Omaha and United Health Care
Washington (GI Rule)
Non-Plan A Medigap plans can change to any other Medigap plan. Plan A must stay on Plan A.