Medicare Supplement Insurance: Your Rights and Protections
There are protections to keep in mind when you first buy a Medigap policy or if your medical insurance coverage changes. These rules are very important in order to purchase the best Medicare Supplement Insurance plan available.
The Best Time to Buy a supplement plan from Medicare?
The most opportune time to buy a Medicare supplemental coverage is when your period of 6 months for open enrollment. Once you sign up for Medicare Part B, you have six months to purchase any Supplemental coverage policy. This six month period is called the period of open enrollment and is offered one time only.
During these six months, an insurance coverage through Medicare Supplement can not turn you down or charged more due to their health problems of todays or of the time gone by. After your six month period of open enrollment ends, insurance companies may have the right to turn you down, not let you buy the plan you want or charge you a higher premium (this leads to higher monthly cost).
Protections from being rejected by the Supplement insurance from Medicare if:
You qualify for special supplemental coverage protections under federal law or you live in a state that has expanded the Supplement Insurance from Medicare during the tenure of six month for open enrollment. The supplement insurance from Medicare protections are explained in the next section. Your state insurance department can tell you if your state allows you to buy a Medicare Supplement Insurance policy at any other time.
If you are under 65 and have Medicare due to a disability, you don't have a Supplemental plan six month time of open enrollment until you turn 65. However, some states require insurers to offer supplemental coverage from Medicare to you. Contact your state insurance department.
Medicare Supplement Protections Pre-Existing Conditions
If you had a health problem before you bought your supplemental Medicare Insurance plan, the Medicare Supplemental Insurance company may refuse to provide coverage in case the person had medical issues in the past six months. A Medicare Supplement Insurance company can only impose this waiting period if it is found that the applicant was suffering from some medical problem in the past siz months before your Medicare advantage plan began.
You may also have a waiting period if you switch to a Medicare Supplement Insurance plan with more benefits. In this case, the waiting period would be for the extra benefits. For example, if you switch from Medicare Supplement Insurance Plan C to supplemental Medicare Insurance Plan F, you might have a waiting period before you begin getting the Medicare part b excess charge benefit.
Some states have a different set of rules about the six month waiting period. If you have a pre existing condition, check with your state insurance department.
Protections from having a pre existing conditions waiting period if:
You buy a Medicare
supplement policy during your six month open enrollment period
and have had at least six months of previous health insurance coverage.
In this situation, the supplement Medicare Insurance company can
not impose any waiting period. If you had less than six months of
health insurance, the waiting period will be reduced by
the number of months you had the health insurance.
Under federal law, you may have special protections that give you permission to enroll in supplemental Medicare Insurance policy after your six month period for open enrollment. These Medicare supplement protections often go into effect when your health insurance changes. For example, you are in a Medicare Health Maintenance Organization (HMO) or Medicare Advantage Plan that leaves your area and you decide to go back to the traditional insurance coverage from Medicare. If you want to buy supplemental Medicare Insurance plan to cover the gaps in original Medicare,
Your rights are:
Buy one of several Medicare Supplemental Insurance plans, not to be charged more, and be covered for all pre existing conditions. Whenever your health insurance plan coverage changes, be sure to keep copies of any letters, notices or claim denials you get.