If you’re currently enrolled in a Medicare Advantage Plan (MAPD), it’s important to know that you may be entitled to Guaranteed Issue Rights—special protections that allow you to purchase certain Medigap (Medicare Supplement Insurance) policies even outside of your standard Medigap Open Enrollment Period.
These rights are designed to safeguard your access to healthcare coverage, particularly when your current Medicare Advantage coverage ends or changes. In qualifying situations, insurance companies are required by law to:
- Sell you a Medigap policy—regardless of any pre-existing medical conditions or your current health status.
- Cover all pre-existing conditions immediately.
- Cannot charge you more for a Medigap policy—must charge you the same regardless of past or present health conditions.
When Do Guaranteed Issue Rights Apply?
You typically qualify for Guaranteed Issue Rights when you lose your existing health coverage, such as a Medicare Advanatge plan, or it changes in specific ways. Common scenarios include:
- Your Medicare Advantage Plan is discontinued or no longer available in your area.
- You’ve had your Medicare Advanatge plan for less than a year & you want to switch to Original Medicare (trial right).
- Your insurance company misled you or failed to follow Medicare rules.
What Is a Trial Right?
If you join a Medicare Advantage Plan for the first time and decide within 12 months that it’s not meeting your needs, you can switch back to Original Medicare and still buy a Medigap policy—with Guaranteed Issue Rights intact. This 12-month period is your “trial right”.
This is especially helpful if you’re exploring your coverage options for the first time and want the reassurance that you can change your mind without penalty.
Why This Matters
Knowing your Guaranteed Issue Rights empowers you to make informed decisions about your healthcare coverage. If your circumstances change, these protections ensure that you’re not left without access to vital coverage—or forced to pay more because of your health history.
If you’re considering a change to your Medicare plan, or if you’re unsure about your eligibility for Medigap under these rules, it’s a good idea to speak with our team of licensed Medicare advisors at Health Benefits Associates. Call us at 775-828-1216 to learn more.
