Medigap: Three Ways to Get Accepted (without underwriting)

by | Feb 27, 2021 | YouTube | 0 comments

Not One, Not Two, Three Paths to Medigap Acceptance

Medigap Open Enrollment is obvious: Starts on the day that your Part B coverage begins, ends in 6 months.
Guaranteed Issue is slighty more difficult, a long list of special conditions where your acceptance is guaranteed by the CMS (Centers for Medicare and Medicaid Services). These are, nevertheless, mandated and enforced by the CMS.

Guaranteed Acceptance (MUCH mote nuanced):
a. States can have expanded rights (example NY State)
b. States can create additional Special Enrollment Periods (this year, Colorado for existing Plan C, F, and F+ policyholders)
c. Carriers can offer additional situations where medical underwriting is relaxed and eliminated

Takeaways: these Guaranteed Acceptance is a Maximize Your Medicare – created term. The clear implications are important.
1. The deadlines established here can change or move, so situations that existed earlier may not exist today.
2. Carriers can change or eliminate their exceptions, this is not a violation of the regulations, since these were greater than the state or federal rules required. Carriers will absolutely follow state and federal regulations (it would be highly impractical / unwise to intentionally violate these regulations).
3. The problem: people misunderstand, people use terminology far too loosely, and these three get mixed up. It is VERY common, even carrier’s applications do not accurately specify which of the three paths is being selected by you, the applicant. This is a VERY regrettable situation, because now you, the applicant, may be relying on misinformation for future decisions.

Notably absent: the Annual Election Period (October 5 – December 7) and Medicare Advantage Open Enrollment Period (January 1 – March 31) are not part of any of these.

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