Guarantee Issue (GI) rights are different when losing coverage vs aging into Medicare. When you age in, you can select any policy without limits; however, when you lose coverage there are only certain options available.
With first dollar plans retiring, options for newly eligible beneficiaries losing coverage will be different than those eligible before 2020.
Rights When Losing Medicare Coverage vs Aging In
Options for coverage are different when you’re aging in vs when you’re losing coverage. Beneficiaries get 63 days to choose from Plans A, B, C, K, L, or F when losing coverage
Due to MACRA, Plan F and C are going away for anyone eligible after 2019. In 2020, Beneficiaries eligible before 2020, will have the same options that are available for 2019. These plans are A, B, C, K, L, or F.
When you turn 65 you’re in an Open Enrollment Period (OEP). This is a period when you can get any Medigap plan you choose with no health questions.
The aging in OEP starts the first day of the month of your 65th birthday and lasts for 5 months. If your birthday is the 1st of the month, OEP begins the month before your 65 birthday.
Basically, you get a 6-month OEP. Also, most Medigap companies accept enrollment as early as 6 months before Part B.
The intention is to allow beneficiaries to lock in the best rate. It’s better to enroll in Medigap when aging in vs losing coverage because you have more plan options.
Know Your Rights When Delaying Part B
There are several reasons to delay Part B. The most common is continuing to work and group coverage is credible. This instance allows you to keep your employer-group plan and delay Part B.
In every situation where the Part B effective date comes after Part A effective date, an OEP begins. The OEP guarantees beneficiaries the right to enroll in any Medigap plan without health questions.
Guarantee Issue rights are Medigap protections. In certain cases, the insurance company is must offer a Medigap plan.
For example, if you have a change in health coverage, or if you were in a trial right.
In these situations, you have GI rights to enroll in some Medigap plans. Be aware, there are still certain plans for which you must qualify.
For example, let’s say you move out of your Part C service area; well, now you have GI rights to but a Medigap plan. So, you can get a Medigap plan that covers all pre-existing conditions with a premium that reflects a healthy person.
Types of Guaranteed Issue Rights
There are 7 situations for allowable GI rights; however, only one situation allows for the selection of any Medigap policy without underwriting. The major difference is between aging in vs losing coverage.
You can use GI rights to enroll in a Medigap plan without answering any health questions. However, only one specific event allows you to enroll in ANY Medigap plan.
The 7 GI Opportunities:
- Moving out of a Medicare advantage area or your plan is going away
- Moving out of a supplement select plan coverage area
- The Medigap company that insures you is going bankrupt
- You were misled
- You’re involuntarily losing group coverage
- You were in a trial right period
Trial Right – You’ve had a Medigap plan since the beginning of Medicare and you’re trying a Medicare Advantage (MA) plan. Within 12 months of the MA effective date, you can drop the MA plan; then you’ll have the option to return to Medicare and the supplement.
Trial Right – You started Part A and B at age 65 and chose an MA plan. You have 12 months from the effective date to drop the MA plan, return to Medicare and pick any Medigap. This is the only event that allows you to enroll in any Medigap plan.
Documents Needed for GI rights When Losing Medicare Coverage vs Aging In
Proof of eligibility is a requirement for enrollment. If you’re losing coverage, your proof is different than if you’re aging into Medicare.
If you’re losing employer coverage, you need the creditable coverage letter the insurance company provides. Keep this letter safe, you’ll need it to buy a new policy with GI rights.
When you age into Medicare, you’re birthday and Part B effective date indicate your eligibility.
GI Rights Under 65 on Medicare
In some states, you’re eligible for OEP and can select a Medigap plan for people under 65. Not all companies offer all plan options for people under 65.
No matter what, when you turn 65, OEP begins. Then, you can choose any plan from any carrier in your area.
We’re here to help and serve you every step of the way. Give one of our agents a call at the number above!
I Thought the ACA Made it Illegal to Penalize Pre-Existing Conditions
Scores of people don’t understand the change the Affordable Care Act brought. While the ACA does prohibit health questions to mainstream America, that doesn’t carry over to supplement plans.
When you apply for a supplement plan you already have Medicare coverage. So, you’re already able to have coverage no matter your health.
The company providing additional coverage can ask health questions and possibly deny the policy. It’s because of these stipulations that it’s imperative you understand the when you need to use GI rights.
Get Help When Losing Medicare Coverage or Aging In
Understanding the eligibility differences between losing coverage vs aging in, can be complex. Don’t hesitate to give us a call at the number above.
We work with many clients and each person has their own needs. Let us help you identify your eligibility status and find the most suitable coverage options for you in your area.
MedicareFAQ works with the Top Insurance Carriers nationally. Our brokers educate and empower you to make an informed decision in regards to Medicare.
So, whether you’re losing coverage or aging in, give us a call at the number above or fill out an online rate form to begin the process.