Medical Underwriting With Medicare

Do I Have to Go Through Medical Underwriting With Medicare?

Medigap (Medicare Supplement) plans are a great way to cover the lapses in Medicare Part A and Part B. However, the application process for enrolling can be complex, and the most challenging part for many people is answering the questions. This part is known as medical underwriting.

Medicare Supplement underwriting is usually needed when you want to switch your Medicare Supplement plan. This information can be used to determine if your application will be accepted. But do you need to go through medical underwriting with Medicare? Let’s find out.

Can I Avoid the Underwriting Process?

Yes, there are a few circumstances in which you don’t have to go through Medicare Supplement Underwriting. This can be vital if the beneficiary has a severe health condition because they may find it difficult to find a provider that will accept them if they have choices. Some health situations give beneficiaries “Guaranteed Issue Rights,” which means they can avoid the underwriting process and be automatically approved for the Medigap plan. Some of the health situations where you can avoid the underwriting process include:

The Beneficiary is in Medicare Supplement Open Enrollment Period (OEP)

The Medicare Supplement OEP starts the month that your Part B coverage starts and lasts for six months. For example, if you start Medicare in June, your Medicare Supplement enrollment period would end in November. Most Medigap insurance providers will also allow beneficiaries to apply for the plan they want six months before their Medicare Part B start date. With that, their Medigap plan will be effective the instant their Medicare coverage starts.

During this window, Medicare beneficiaries will enroll for a plan with any carrier with no underwriting. So, it is vital to take advantage of this window because that is the only time you can avoid underwriting.

Some States Have Special Rules

If you live in Missouri, you can apply for a Medicare Supplement plan around your coverage’s anniversary date.

If you live in states like Maine, Washington, Connecticut, or New York, you may be able to change your Medicare Supplement plan without undergoing the underwriting process. If you live in Oregon or California, you can apply for a Medicare Supplement plan around your birthday.

The Medicare Supplement Coverage Lost is Not Your Fault

If you lost your coverage due to reasons beyond your control, you could get guaranteed issue rights. For example, if you had a MA plan but was dropped by your provider because you moved out of the network coverage area, you may get a guaranteed issue right.

Remember that most of the guaranteed issue right conditions are time-sensitive. So, if it is not your fault that you lost your coverage, you should work with your insurance agent as soon as possible to work on your timeline.

If you have more questions about Medicare Supplement underwriting, call Temmen Insurance for help. Our insurance agents will be happy to help answer any questions you have.

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