Coverage Rights Guide

When Medicare Supplement Companies
Can Deny Your Coverage

Understanding your rights and when insurance companies must accept your application can save you from coverage denials and higher premiums.

Quick Answer: It Depends on Timing

They CANNOT deny you during your 6-month Open Enrollment Period when you turn 65, or during special guaranteed issue situations.

They CAN deny you outside these protected periods due to health conditions, pre-existing conditions, or medical history.

🛡️ Understanding these rules is crucial to avoid being locked out of Medigap coverage.

When Companies CANNOT Deny You

Guaranteed Issue Rights

Federal Legal Protection

Open Enrollment Period (Most Important)

6 months starting when you turn 65 AND enroll in Medicare Part B

  • • No health questions allowed
  • • Cannot deny for any reason
  • • Cannot charge higher premiums
  • • Must sell any plan they offer in your state

Losing Other Coverage

When group coverage ends (63-day window)

  • • Employer insurance ends
  • • COBRA expires
  • • Union coverage terminates
  • • Spouse's coverage ends (divorce/death)

Medicare Advantage Problems

When your MA plan has issues

  • • Plan leaves Medicare
  • • Plan stops serving your area
  • • Plan violates Medicare contract
  • • Trial right (switching back to Original Medicare)

Special Situations

Additional Protections

Working Past 65

Delayed Medicare due to employer coverage

  • • 6-month window starts when you enroll in Part B
  • • Not when you turn 65
  • • Must have creditable coverage

Disability Medicare

Special rights at age 65

  • • New 6-month open enrollment at 65
  • • Even if you've had Medicare for years
  • • Can switch from current Medigap plan

State-Specific Rights

Some states provide extra protections

  • • California: Birthday Rule
  • • Oregon: Birthday Rule
  • • Other state programs vary

⚠️ Critical Timing Rules

Most guaranteed issue rights have strict deadlines - typically 63 days from losing coverage. Missing these deadlines means you'll face medical underwriting and possible denial.

When Companies CAN Deny You

Medical Underwriting

Outside Protected Periods

Outside of guaranteed issue periods, insurance companies can use medical underwriting to decide whether to accept your application.

When This Applies

  • • After your 6-month open enrollment period
  • • No qualifying guaranteed issue event
  • • Switching plans outside protected periods
  • • First-time Medicare enrollment after age 65

Health Questions They Ask

  • • Current medications
  • • Recent hospitalizations
  • • Chronic conditions
  • • Scheduled procedures
  • • Doctor recommendations

Common Denial Reasons

Health-Based Decisions

High-Risk Conditions

  • • Heart disease or recent heart attack
  • • Cancer (current or recent treatment)
  • • Kidney disease or dialysis
  • • Stroke or neurological conditions
  • • Diabetes with complications

Recent Medical Events

  • • Hospitalization in past 6 months
  • • Scheduled surgery or procedures
  • • Recent diagnosis of serious condition
  • • Doctor-recommended tests pending

Alternative Outcomes

  • • Outright denial
  • • Higher premiums (rate-ups)
  • • Exclusion riders for specific conditions
  • • Waiting periods for pre-existing conditions

Coverage Timeline: What Changes When

65

Turning 65 & Enrolling in Medicare Part B

6-Month Guaranteed Issue Period Begins

What You Can Do:

  • • Buy any Medigap plan sold in your state
  • • No health questions
  • • No medical exams
  • • Cannot be denied
  • • Standard pricing

Time Limit:

Exactly 6 months from the first day of the month you turn 65 AND have Part B coverage.

6M+

After 6-Month Period Ends

Medical Underwriting Begins

What Changes:

  • • Must answer health questions
  • • May require medical exams
  • • Can be denied for health reasons
  • • May face higher premiums
  • • Exclusion riders possible

Still Available:

You can still apply, but acceptance isn't guaranteed and you may pay more or have conditions excluded.

Special Guaranteed Issue Events

Protection Returns Temporarily

When you lose other coverage or have Medicare Advantage problems, you get temporary guaranteed issue rights again.

⚠️ Usually limited to 63 days from the qualifying event

State-Specific Protections

CA

California

Birthday Rule

Within 30 days of your birthday, you can switch to a plan with equal or lesser benefits without underwriting.

Additional Rights

Continuous open enrollment for certain plans and situations.

OR

Oregon

Birthday Rule

Similar to California - annual opportunity to switch to equal or lesser benefits.

Open Enrollment

Some additional open enrollment opportunities beyond federal requirements.

Other States

Federal Rules

Most states follow federal guaranteed issue rules with limited additional protections.

Check Locally

Some states may have additional consumer protections not widely advertised.

What You Should Do

1

If You're Approaching 65

Don't delay! Start shopping during your 6-month guaranteed issue period. This is your best and possibly only chance for guaranteed coverage.

✓ Apply even if you're healthy - rates and acceptance won't get better

2

If You Missed Your Window

You can still apply, but be prepared for medical underwriting. Consider applying to multiple companies as each has different underwriting guidelines.

⚠️ Work with an experienced agent who knows carrier-specific underwriting

3

If You Have a Qualifying Event

Act quickly! Most guaranteed issue rights expire 63 days after the qualifying event. Document everything and apply immediately.

🕒 Time limits are strictly enforced - don't wait

Related Articles

Medicare Supplement Open Enrollment Guide

Critical differences between enrollment periods and when you can enroll.

Plan G vs Plan N Cost Analysis

Complete cost comparison to help you choose the right Medigap plan.

Understanding Guaranteed Issue Rights

Detailed guide to all guaranteed issue situations and timing requirements.