What is Medicare Guaranteed Issue Period?

2 min. readlast update: 07.03.2023

The Medicare Guaranteed Issue (GI) period is a specific enrollment period during which individuals have the right to enroll in a Medicare Supplement (Medigap) plan without being subject to medical underwriting. This means that insurance companies cannot deny coverage, charge higher premiums, or impose waiting periods based on an individual's health condition or pre-existing conditions.

Here are some key points about the Medicare Guaranteed Issue period:

  1. Timing: The Guaranteed Issue period occurs at certain times when individuals have a guaranteed right to purchase a Medicare Supplement plan. The circumstances that trigger the Guaranteed Issue rights are defined by federal law.
  2. Initial Enrollment Period (IEP): The first opportunity for guaranteed issue rights occurs during the individual's Initial Enrollment Period, which starts when they are both 65 or older and enrolled in Medicare Part B. During this period, which lasts for six months, insurance companies must offer Medigap coverage without medical underwriting.
  3. Medigap Open Enrollment Period (OEP): If an individual missed their Initial Enrollment Period, they can still qualify for the Medigap Open Enrollment Period. The OEP is a one-time, six-month period that begins on the first day of the month an individual is at least 65 years old and enrolled in Medicare Part B. Like the IEP, during this period, insurance companies cannot deny coverage or charge higher premiums based on health conditions.
  4. Other Guaranteed Issue Rights: There are additional circumstances that may trigger Guaranteed Issue rights outside the Initial Enrollment Period and Medigap Open Enrollment Period. These include situations such as losing existing coverage (e.g., employer or union coverage), moving out of a Medicare Advantage plan's service area, or discontinuation of a Medicare Advantage plan or Prescription Drug Plan.
  5. State-Specific Guaranteed Issue Rights: Some states have additional Guaranteed Issue protections beyond what is provided under federal law. These state-specific rules may provide individuals with additional opportunities for guaranteed enrollment in a Medicare Supplement plan.

It's important to note that the Guaranteed Issue period applies only to Medicare Supplement plans (Medigap) and not to other parts of Medicare, such as Part C (Medicare Advantage) or Part D (prescription drug coverage). Medicare Advantage and Part D plans have separate enrollment periods and rules.

If you're considering enrolling in a Medicare Supplement plan during a Guaranteed Issue period, it's advisable to compare the available options and seek guidance from insurance professionals or Medicare representatives to ensure you understand the coverage and make an informed decision.

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