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Medicare: Enrolling In Medigap With A History Of A Serious Medical Condition

Other Opportunities To Enroll In Medigap Without Medical Underwriting

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In some state, such as New York, you can obtain Medigap insurance without limitation.

In all states, there are some other occasions when an insurance company must offer Medigap coverage without regard to your health or medical history:

If you enrolled in a Medicare Managed Care Plan or Medicare SELECT (see below) when you first became eligible for Medicare and you choose to leave the Medicare Managed Care Plan or Medicare SELECT plan within one year after joining.

If both these factors occur:

  • You have the right to purchase any Medigap policy available in your state, provided you purchase the Medigap policy within 63 days of leaving the Medicare health plan.
  • The Medigap policy cannot require medical underwriting
  • The Medigap policy must cover all pre-existing conditions
  • The insurer cannot charge you more because of your existing medical condition or health history.

If you dropped a Medigap policy to join a Medicare Advantage plan or a Medicare SELECT policy for the first time and then leave the plan within one year of joining.

You have the right to return to your former Medigap policy from the same insurance company provided you apply no later than 63 days after the Medicare health plan coverage ends. (Notice that the key here is 63 days after you apply. It is not tied to the date of issue of the Medigap policy.)

If your former policy is not available, you have the right to buy Medigap plans A, B, C, or F (whichever are sold in your state) as long as you apply within 63 days after your Medicare health plan coverage ends.

You cannot be denied coverage, have a pre-existing conditions waiting period imposed, or be charged more due to your medical condition.

If your Medicare health plan or your current Medigap policy ends, you may have the right to purchase a Medigap policy in certain circumstances.

If your Medicare health plan or your current Medigap policy ends, you have the right to purchase a Medigap policy if any one of the following occur:

  • Your Medicare health plan stopped participating in Medicare or giving care in your area.
  • You move outside the plan's service area.
  • You leave the health plan because it failed to meet its contract obligations to you.
  • You were in an employer group health plan that supplemented or was a secondary payer to Medicare (see Medicare -- Coordination of Benefits), and the plan ends your coverage.
  • Your Medigap policy or Medicare SELECT policy ends, and you're not at fault (such as the company goes bankrupt).

In these cases you must be allowed to purchase Medigap plans A, B, C, or F - whichever are sold in your state:

  • Without medical underwriting.
  • Without imposing a waiting period for pre-existing medical conditions.
  • Without charging more because of your medical history.

In most cases, you must stay in your health plan until the date your coverage ends. If you leave the plan before the announced termination date of your coverage, you may lose your right to guaranteed Medigap coverage.


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