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What You Need to Know About Guaranteed Issue in Medicare Supplement Plans

04.22.2011 · Posted in Health

Medigap is the insurance policy that answers for the parts that are not provided for by Medicare. It is also called as Medigap supplement plans. These insurance plans have “Guaranteed Issue” which states that you can have a supplement plan without any chance of denying your application, without taking into effect your existing health conditions and without raising its rates. This is a part of the federal mandate that regulates all Medicare enrollees.

GI comes to use when your Medicare plan is changing or when you are involuntarily stripped as the holder of the plan. There are Medicare supplement companies that make their own situations that can trigger the use of GI. However, there are seven GI core situations that are prescribed by federal mandate for insurance companies like:

1. You have a union or employer paying your Medicare and now the coverage is going to stop.

2. You have a Medicare Advantage plan but this is already detaching from the Medicare program or stop catering to your area or you are moving out of the plan’s area of coverage.

3. You have a Medicare SELECT policy and you are going to transfer to another area of coverage. You can keep paying your current policy but based on GI, you can also find another policy.

4. Your insurance company for the Medicare supplement coverage goes bankrupt, ending your coverage or you lost your plan due to reasons that are not your fault.

5. You have a Medicare Advantage plan when you initially enrolled upon your eligibility for the coverage but after a year, you would like to be covered under the original Medicare and have a Medicare supplement plan as well.

6. You wanted to enroll in Medicare Advantage of SELECT policy as a first time enrollee so you left your Medicare supplement. However, less than a year after you did this, you want to go back to your Medigap plan.

7. You wanted to leave your Medicare Advantage plan or supplement plan when you discovered the insurance company does not follow the law.

 

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