A guaranteed issue right means you can buy a Medicare Supplement (Medigap) policy regardless of your health history. Insurance companies must sell you a policy, cannot deny you coverage, and cannot charge more because of pre-existing conditions. These rights apply only in specific situations, usually when you lose or change other Medicare coverage.
Why Guaranteed Issue Rights Matter
If you don’t have a guaranteed issue right — and you’re outside your Medigap Open Enrollment Period — insurers typically use medical underwriting. This process may result in denial of coverage or higher premiums. Guaranteed issue rights protect you from that risk.
Situations That Qualify for Guaranteed Issue Rights
There are several scenarios where you may qualify for guaranteed issue rights, including:
- Your Medicare Advantage plan leaves your service area or ends coverage.
- You move out of your Medicare Advantage plan’s service area.
- Your employer or union coverage that supplements Medicare ends.
- You lose coverage through a Medigap or Medicare Advantage plan due to no fault of your own.
- You joined a Medicare Advantage plan when first eligible and left within the first 12 months.
- You dropped a Medigap policy to join a Medicare Advantage plan and want to switch back within 12 months.
- Your Medigap or Medicare Advantage plan coverage ends due to company bankruptcy or misrepresentation.
- Other special protections defined by federal or state rules.
In most cases, you must apply for a new Medigap policy within 63 days of losing prior coverage. Be sure to save all letters, claims, and notices from your plan to prove your eligibility.
Which Plans Are Available?
Guaranteed issue rights give you access to certain Medigap plans only. In most states, you can choose from Plan A, Plan B, Plan C, Plan F, Plan K, or Plan L. If you live in Massachusetts, Minnesota, or Wisconsin, different standardized plans apply.
Next Steps
To avoid gaps in coverage, apply for a Medigap policy before your current coverage ends. Your new Medigap policy can begin the same day your old one ends. Learn more about buying a Medigap policy and use our plan comparison tool to explore options available in your state.