Medicare Supplement Guaranteed Issue

To be eligible to apply for a Medicare Supplement, normally you must apply within 6 months after enrolling in your Part B medicare, and you must be enrolled in both Part A & Part B. Or you able to switch plans under the California Birthday Rule.

Otherwise, to switch your Medicare Supplement without the need for Medical Underwriting, you must have Guaranteed Issue under one of the following provisions:

  • You have lost or terminate health coverage under certain circumstances;
    1. You have lost or are replacing a plan that was provided by your current or former employer or the employer no longer covers all of the Medicare Part B coinsurance.
    2. You have lost access to a county, state or federal medical program (such as Medi-Cal,)
    3. You are replacing a Medicare Advantage (MA) plan or a Program of All-Inclusive Care for the Elderly (PACE) or a Medicare Select plan, under these circumstances:
      • This was your first time on such a plan,
      • You switched to this plan from a Medicare Supplement plan, and
      • You’ve had it for no longer than two years.
    4. You are replacing a Medicare Advantage (MA) plan or a Program of All-Inclusive Care for the Elderly (PACE), under these circumstances:
      • You enrolled in the MA plan when you started Medicare Part A at age 65 and
      • You’ve had it for no longer than 1 year.
    5. You are replacing a Medicare Advantage (MA) plan or a Program of All-Inclusive Care for the Elderly (PACE) or a Medicare Select plan, under any one of these circumstances:
      • The plan stopped coverage in your area,
      • The plan notified you it will be stopping coverage in your area, or
      • You moved out of the plan’s service area.
    6. You are replacing a Medicare Advantage plan or Medicare Select plan that was ended by the company (for example, due to bankruptcy),
    7. You are replacing a Medicare Advantage (MA) plan or a Program of All-Inclusive Care for the Elderly (PACE) or a Medicare Select plan, under these circumstances:
      • The plan’s premiums increased by 15% or more,
      • Raises the co-payments for physician or hospital services by 15% or more,
      • Discontinues, for other than good cause relating to the quality of care, its relationship or contract under the MA plan with a provider who is currently furnishing services to you.