‘Guaranteed Issue’ periods are present in Medicare Supplement insurance which allow people to apply for a specific plan without being denied the coverage. It may however exclude the pre-existing conditions or could charge the person more due to the presence of any kind of health conditions. Such guaranteed issue rights are said to be mandated Federally by Centers for Medicare and Medicaid Services. At the same time, it applies to all the Medicare enrollees who are in any of the specific situations.
Generally, the GI rights tend to occur when the person’s existing healthcare coverage in certain way has been changing or the person is losing his coverage involuntarily. There are some insurance providers, who may develop their very own GI situations. The Federally prescribed GI situations are stated to be seven in number which is followed by visiting http://www.medisupps.com/medicare-supplement-plans-2017. In case, the person falls into any of the periods, then would be able to register with the Supplement plan on Guaranteed Issue basis.
Knowing the situations
They are as follows:
- He has a union or employer coverage which makes AFTER Medicare payments and is termed to be an ending coverage.
- He has Medicare SELECT policy. He is moving out of service area of the plan. It is possible to keep the existing policy, however, has the right, on GI basis for switching to the new policy.
- He is enrolled with Medicare Advantage plan. The plan could be leaving Medicare program, have servicing stopped in the specific area. It could also be that the person is out of range of the service area of the plan because of moving out.
- He has enrolled with PACE or Medicare Advantage plan initially, but has the desire to switch back to the original Medicare ( as well as Medicare Supplement insurance plan) within a year of getting enrolled.
- The Medicare Supplement provider from where the person has availed the plan has gone bankrupt, causing him to lose precious coverage. It could also be that he has lost his supplemental plan coverage for none of his fault.
- Medigap or Medicare Advantage policy is desired to be dropped, since rules or not followed by the company or the person has been misled in some way.
- He has dropped the Medicare Supplement for switching to the Medicare SELECT or Medicare Advantage policy initially. After being lesser than a year, he has plans to switch to Medigap policy.
Also few specific GI situations may have specific plan requirements, which one can enroll with.