Can You Be Denied Supplemental Insurance for Medicare?

If you’re concerned that you might be denied Supplemental Insurance for Medicare, keep reading to find out more.

Signing up for supplemental insurance in addition to Original Medicare can be simple. When you turn 65 and have Part B, you have a six-month window to sign up for supplemental insurance during your Open Enrollment Period.

Easy Article Navigation

• When is a Medicare Supplement Guaranteed Issue?
• When Can You be Denied Medicare Supplemental Insurance?
• Can my Medicare Supplement Plan be Non-Renewed?
• What about Medicare Supplemental Insurance for Disabled Under 65?
• When are the Medicare Enrollment Deadlines?
• Can I Opt-Out of Original Medicare?
• Frequently Asked Questions

Moreover, the companies that offer Medicare Supplement plans must sell you the plan of your choice at the best available rates without regard to any preexisting conditions.

However, make sure that you apply for coverage during your six-month open enrollment period so your application is not medically underwritten. Outside of your open enrollment period, the insurance company can charge higher rates, apply waiting periods, or even deny coverage for preexisting conditions.

When is a Medicare Supplement Guaranteed Issue?

Unlike private health insurance plans, applicants can purchase a Medicare Supplement with guaranteed issue rights, but not always.

Guaranteed issue rights are extremely important if you have current or previous health issues because the insurer can hold these preexisting issues against you and increase your insurance premium or even decline your application.

Thankfully, there are two situations when you can purchase a Medicare Supplement (Medigap) plan under guaranteed issue rights:

1. If you are purchasing your supplemental insurance within your Open Enrollment Period (OEP) which is the six months immediately following your 65^th birthday and enrolled in Medicare Part B.
2. The second situation when you have guaranteed issue rights is when you are enrolled in a Medicare Advantage plan and your plan stops offering care in your area or you’re moving out of the service area or you are losing other health insurance because of a situation outside of your control.

To be absolutely sure about whether your application will be medically underwritten or guaranteed issue, check with a Medicare Supplement specialist or visit Medicare.gov to determine your status.

When Can You be Denied Medicare Supplemental Insurance?

Although Medicare Supplement plans are generally not medically underwritten for most applicants, there are situations when you can be denied coverage. It’s all about the timing:

• If you are purchasing coverage during your Open Enrollment Period, insurers cannot medically underwrite your policy meaning they cannot increase your rates or deny you coverage because of preexisting health conditions.
• If, however, you attempt to purchase a Medicare Supplement plan outside of your Open Enrollment Period (starts when you are 65 and enrolled in Medicare Part B, and runs for six months), your insurer will likely medically underwrite your policy because and either charge more premium, place a waiting period on preexisting conditions, or deny coverage.

Preexisting conditions that typically result in a denial of coverage are heart conditions, kidney conditions, cancer, chronic lung disease, and AIDS. Other conditions that are considered acute may also land in the decline stack as well.

Most applicants that have typical health conditions like arthritis and diabetes will generally see a small rate increase as long as the conditions are being managed.

Can my Medicare Supplement Plan be non-Renewed?

Generally, Medicare Supplement (Medigap) policies are automatically renewed. But, there are certain circumstances when an insurance company can elect not to offer a renewal:

• You haven’t made premium payments regularly
• You lied or omitted information on your application
• Your Medicare Supplement insurance company declared bankruptcy

Additionally, Medicare Supplement plans sold before 1992 are not considered guaranteed renewable, but the insurance company will need the state’s permission to non-renew your plan but you always buy a plan from another insurer.

What About Medicare Supplemental Insurance for Disabled Under 65

Yes, you can purchase a Medicare Supplement plan if you are disabled and under age 65, however, the qualifications are controlled by the states. This means that some states require a certain type of disability like End-Stage Renal Disease (ESRD) while other states are more lenient.

To determine your state’s requirements please visit this page: https://mymedicaresupplementplan.org/medicare-supplement-insurance-under-65/

The states that allow you to purchase a Medicare Supplement (Medigap) plan under the age of 65 also provide guaranteed issue rights to the applicant as long as the applicant applies during their open enrollment period.

Qualified applicants under 65 that have Medicare Part A and Part B must be able to purchase at least one plan from an insurer approved in that state but in many cases, the approved insurers will offer more.

When are the Medicare Enrollment Deadlines?

For people who are receiving or eligible to receive Social Security benefits, Social Security will send you instructions for signing up three months before the month you turn 65. People who are receiving Social Security benefits will not be charged for Part A which covers hospital visits and services. Part A also covers hospice and skilled-nursing services as well as some home health care.

Part B is similar to traditional health insurance and comes with a base monthly premium that generally changes each year. Individuals who are considered high-income earners will pay more than the base rate depending on their annual income.

Folks who are living outside the United States or are traveling abroad should contact the closest Embassy or consulate to request enrollment forms.

The actual enrollment period for Original Medicare begins three months before you turn 65 and continues for an additional three months thereafter.

 

Can I Opt-Out of Original Medicare?

You can opt-out of Medicare Part B if you have primary health coverage through an employer, union, on a spouse’s plan, or are receiving veterans’ benefits but you should confirm with your health insurance provider that your plan will meet the Medicare standard.

If you choose to opt-out because of access to other coverage, it will not have an impact on your Social Security status, however, if you decide to enroll in Medicare Part B later, you’ll likely pay a penalty and have permanently higher premiums when you sign up.

Additionally, you cannot enroll in a Medicare Supplement Plan (Medigap) or Medicare Advantage plan (Medicare Part C) without being enrolled in Medicare Part B.

Frequently Asked Questions