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Every Medicare recipient has the right to apply for Medicare supplemental insurance (“Medigap” insurance). The rules allow for a six-month open enrollment period that begins on the first day of the month in which you are both 65 years old or older and have signed up for Medicare Part B benefits. During the open enrollment period, Medicare supplement insurance companies must sell you the Medigap policy of your choice from among a mostly standardized choice of 12 plans, assuming any of the insurance companies that can sell policies in your state offer all 12 plans. You cannot be refused because of pre-existing conditions or forced to pay more than other people for a particular plan because of your health status. Guaranteed issue rights can come into the picture during the open enrollment period or beyond your open enrollment period. Under certain circumstances, Medicare supplement insurance companies can delay coverage of pre-existing conditions for up to six months, even though you buy your plan during your open enrollment period. If you have a guaranteed issue right, the companies cannot delay coverage. Guaranteed issue rights also apply in these circumstances: • Your Medicare Advantage plan leaves Medicare or stops providing care, or you move away
• You have an employer or union group health plan and Original Medicare (Medicare Parts A and B) and the non-Medicare insurance ends
• You move out of a Medicare SELECT policy service area and also have Original Medicare
• You change from a Medicare Advantage plan or PACE (Programs of All-inclusive Care for the Elderly) to Original Medicare even though you signed up for one or the other of the former programs
• You have been in a Medicare Advantage or SELECT plan for less than a year after dropping a Medicare supplemental insurance plan but want to change back to the Medigap plan
• Through no fault of yours, your Medicare supplemental insurance company no longer provides coverage
• Your insurance company fails to follow regulations and your drop your Medicare Advantage or Medicare supplemental insurance plan because of the violation A number of other factors are in play under each of the above scenarios, so it’s best to talk with your State Health Insurance Assistance Program or a qualified insurance agent with expertise in supplemental Medicare insurance. Be sure to hold on to any proof of coverage and claim denials from health insurance you have had before applying for a Medigap policy. They can be very helpful in establishing your guaranteed issue right. For more than 35 years, the Richardt Insurance Agency has been offering advice and helping clients work with insurance companies to develop the most cost-effective Medicare supplemental insurance quote. Richardt Insurance serves clients through agents with expertise in Medicare supplemental insurance in Texas, Arkansas, Oklahoma, Kansas and Missouri. They help clients find the Medicare supplemental insurance coverage that provides the right coverage at the right price to suit their needs. For a Medicare supplemental insurance quote, contact a Richardt Insurance agent. Visit www.richardtinsurance.com for information.
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Medicare Supplemental Insurance, Medigap, Medicare supplement insurance companies,
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