Short answer: You may be able to buy a Medigap policy without medical underwriting if your Medicare Advantage plan leaves Medicare, stops serving your area, or you move outside its service area. These federal guaranteed-issue rights are time-limited and generally require you to return to Original Medicare.
What is a guaranteed-issue right?
A guaranteed-issue right means an insurer must sell you certain Medigap policies available under the applicable rule, cover pre-existing conditions, and not charge more because of health problems. It is different from Medicare’s Special Enrollment Period for health or drug plans.
When plan cancellation may qualify
Medicare’s Medigap guide lists protection when a person has Medicare Advantage and the plan leaves Medicare, stops giving care in the person’s area, or the person moves outside the service area. The protection generally applies only when the beneficiary switches to Original Medicare rather than another Advantage plan.
What is the deadline?
Under the federal protection described by Medicare, an eligible person can generally apply from 60 days before Advantage coverage ends through 63 days after it ends. Apply early when possible so the Medigap effective date can be coordinated with Original Medicare.
Which policies can I buy?
The federal guide identifies certain standardized plans that must be offered under this guaranteed-issue situation, subject to availability and eligibility rules. People newly eligible for Medicare after January 1, 2020 cannot buy Plans C or F. State law may create broader rights, different deadlines, or additional options.
Documents to keep
• The cancellation, non-renewal, or service-area letter. • Proof of the coverage-ending date. • Your Medicare card and Advantage membership card. • Applications, confirmations, and notes from calls. • Any written explanation of guaranteed-issue eligibility.
Medigap does not include Part D
A Medigap policy supplements Original Medicare; it does not replace Part A or Part B and does not include modern outpatient drug coverage. Consider a stand-alone Part D plan separately.
Frequently asked questions
Can a Medigap company ask health questions? - It may ask for information, but when a valid guaranteed-issue right applies, it cannot use health status to deny the protected policy or charge more because of health problems. Do all plan cancellations create Medigap rights? - No. An individual disenrollment for reasons such as nonpayment may not create the same federal protection as a plan leaving Medicare or the service area. Are state rules different? - They can be. Contact the State Insurance Department or SHIP for state-specific protections. Official resources - Choosing a Medigap Policy (https://www.medicare.gov/publications/02110-medigap-guide-health-insurance.pdf) · Medicare Medigap information (https://www.medicare.gov/health-drug-plans/medigap)