Is Medigap Available If Your Medicare Advantage Plan Terminates

October 30, 2024|Medicare Insights, Newsroom

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October 30, 2024 – Los Angeles, CA – Millions of American seniors with Medicare Advantage coverage are scurrying to find new coverage for 2025.

According to the American Association for Medicare Supplement Insurance, the total number of Medicare Advantage plans declined by 7% from 3,959 to 3,699. This indicates that a significant number of plans are being terminated or not offered for the upcoming year.

Impacted individuals can search for new Medicare Advantage plan coverage. Or, they may benefit from special circumstances that permit them to apply for Medigap coverage without having to meet health qualifications. This is referred to as “guaranteed-issue”.

Without guaranteed-issue rights, the insurance company may require medical underwriting before it offers you a plan. The insurer will examine your past medical history and current health status. If the company determines the risk of covering you is too high, it can refuse to offer you the plan you want, or it may charge you much higher premiums for the coverage.

From Medicare Advantage to Medigap

Getting guaranteed-issue Medigap coverage if your Medicare Advantage plan has been cancelled may be possible.

But, everything must be done correctly and within a very short permitted number of days. For that reason, we strongly suggest working with an experienced local Medicare insurance agent. Simply explained, if you switch to Original Medicare (you can do this during Medicare’s AEP that ends December 7th), you have short-term guaranteed-issue rights for a Medicare Supplement (Medigap) insurance plan.

However, this special situation may limit your choice of Medicare Supplement (Medigap) insurance plans. Although there are 10 standardized plans available in most states, some states only allow you to buy certain ones with guaranteed-issue rights outside your Initial Enrollment Period. And, the window to do all of this can be extremely short – basically 63 days.

Pros Of Switching To Medigap

There are a number of reasons to consider switching to a Medigap plan, especially if you can qualify for guaranteed-issue coverage. You are not limited to specified provider networks.

Medigap can cover up to 100% of most out-of-pocket expenses. Referrals not required to see specialists. And, few to no approvals are needed for services and supplies