Medicare Insurance Rights

Medicare Supplement Insurance: Your Rights and Protections

 

There are protections to keep in mind when you first buy a Medicare supplement insurance plan (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 Medicare Supplemental Insurance Plan?

The best time to buy a Medicare supplement iInsurance plan is during your six month open enrollment period. Once you sign up for Medicare Part B, you have six months to purchase any Medicare supplemental insurance policy. This six month period is called the six month open enrollment period and is offered one time only.

During these six months, an Medicare supplement insurance company can not turn you down or charge you more because of your past or present health problems. After your six month open enrollment period 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 Medicare supplement insurance plan if:

You qualify for special supplemental Medicare insurance protections under federal law or you live in a state that has expanded the Medicare supplement insurance six month open enrollment period. The Medicare supplement insurance 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 Medicare supplement insurance six month open enrollment period until you turn 65. However, some states require insurers to offer Medicare supplement insurance plans to you. Contact your state insurance department.

Read Complete Guide to Medigap Insurance

 

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 cover this health problem for up to six months. A Medicare supplement insurance company can only impose this waiting period if the health problem was diagnosed or treated during the six 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.

It is very important that you tell the insurance company selling the Medicare insurance about your previous health insurance coverage. You want to switch supplemental Medicare insurance companies, change Medicare supplement insurance plans at the same Medicare supplemental insurance company, or both, and you have had a Medicare supplement insurance policy for at least six months, and you buy a plan that covers the same or lower level of benefits, let them know that.

Your Right to Buy a Medicare Supplement Policy

 

Under federal law, you may have special protections that give you the right to buy supplemental Medicare insurance policy after your six month open enrollment period. 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 original Medicare insurance plan. 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.