With ‘Guaranteed Issue’ terms in Medicare Supplement Plans, you are able to apply for any plan without worrying about your insurance company excluding your pre-existing health issues, charging you more or denying you the policy coverage. And since these GI or guaranteed issue rights are mandated by the Federal Law, they apply to every single Medicare enrollee with one of these specific conditions.
Typically, the GI rights can be applied when the health care coverage you presently have changes in a specific way or you end up losing your coverage involuntarily. Some insurance agencies may come up with their individual GI guidelines; but, there are 7 GI situations prescribed by the Federal Government which must be followed by every company that sells the supplemental plan. In case you fall in one of the listed periods, you are allowed to register for this plan on a GI basis.
7 Situations Eligible for GI Term:
- The union or employer coverage of the senior which compensates for AFTER Medicare is closing.
- The senior has purchased the Medicare Advantage policy, and this coverage is leaving the Medicare plan, is no longer servicing your region, OR you’re relocating out of the area specified by the plan.
- The senior is enrolled in a Medicare SELECT plan and moving away from the service region of the plan. In this case, the senior can keep his/her present policy, however, he/she can also opt for a new coverage on a GI basis.
- The insurance company offering the supplemental plan goes bankrupt causing the senior to lose his/her coverage. OR, the senior loses the supplemental plan for no specific reason.
- The senior is enrolled in the PACE or Medicare Advantage policy when he/she was initially eligible for enrollment, and inside 365 days of joining, they want to move back to their “initial” Medicare.
- The senior decided to drop the Medicare Supplement so as to pick a Medicare SELECT or Medicare Advantage plan for the first time. The senior is enrolled in that policy for a year or less and want to opt for Medigap.
- The senior decided to leave the Medicare Advantage coverage or drop the Medigap plan because they realized that the insurance company did not follow the guidelines or misled him/her in a certain way.
All the states are also given equal authority to come up with further GI situations. Some states have already implemented them. It’s important that you understand these GI situations in case you’re a Medicare policyholder.