Page 18 - APPENDICES for Steve Dickhaus

Medigap Guaranteed Issue Rights in Minnesota

Guaranteed issue rights are rights you have in certain situations when insurance companies are
required by law to sell you specific Medigap policies outside of your initial open enrollment period,
even if you have a pre-existing health condition.

Policies That Can be Purchased with Guaranteed Issue Rights
You can purchase a Basic Medigap policy if you have guaranteed issue rights. You can also add two
optional riders: Medicare Part A Deductible and Medicare Part B Excess Charges. Your guaranteed
issue rights do not apply to the Medicare Basic Preventive Rider or other Medigap policies.

General Eligibility Criteria
Companies are required to sell you a policy outside your initial enrollment period when:
• Your Medicare health plan or Medigap policy is no longer offered.
• You have Original Medicare and an employer group health plan (including retiree coverage) that
pays after Medicare pays and that plan is ending.
• You move away from your Medicare health plan or Medicare SELECT plan service area.
• You lose coverage because the insurance company goes bankrupt.

Trial Right Eligibility Criteria
You are eligible for a trial right period if you:
• Join a Medicare Advantage Plan when you first became eligible for Medicare at age 65.
○ During the first 12 months, you can to switch to Original Medicare and purchase a Medigap
policy.
• Drop a Medigap policy to join a Medicare Advantage Plan for the first time.
○ During the first 12 months after enrolling in the new plan, you can return to Original Medicare
and the Medigap policy you dropped.
• Leave a Medicare Advantage or Medicare Cost Plan or drop a Medigap policy, because the company
had not followed the rules or has misled you.

Length of Special Enrollment Period
If your plan is ending and you have guaranteed issue rights, you will have a special enrollment period.
• In most cases, you have up to 63 days from your coverage end date to purchase a new Medigap policy.
• If possible, apply before your current coverage ends.

Showing Proof of Eligibility
You must show that you have guaranteed issue rights to the insurance company prior to enrollment
into a new policy. Keep the following items as proof:
• Letters, notices and claim denials that show coverage was terminated.
• Postmarked envelopes, which show dates mailed.
• Anything from the insurance company with your name on it.

20 Medigap Guaranteed Issue Rights in Minnesota