If you have any pre-existing medical conditions, changes to your Medigap Plan made outside the Open Enrollment Period may limit your plan choices.
Fortunately, Guaranteed Issue rights offer relief if your coverage is lost due to a qualifying event, allowing you to choose a plan even if you have a pre-existing condition. But, these rights may differ across states based on your situation.
Let's look at Guaranteed Issue rights and how they vary from state to state.
Guaranteed Issue Rights, also called Medigap Protections, are your rights in specific situations that permit you to choose any Medicare Supplement ( Medigap
In medical underwriting, insurance companies examine your medical history, including your medical records and prescription history, to determine whether to offer insurance and at what cost.
If you have guaranteed issue rights, insurance companies:
Are legally obligated to sell you a Medicare Supplement (Medigap) policy
Cannot reject your application
Must cover all your pre-existing conditions
Cannot overcharge you due to a pre-existing condition
Guaranteed Issue Rights are only available under specific conditions, so it's good to enroll in a Medigap or Medicare Supplement plan during your Medigap Open Enrollment Period
You're eligible for guaranteed issue rights under the following situations:
If you're enrolled in a Medicare Advantage plan
It will no longer be part of Medicare
It's discontinuing its service in your region, or
You move outside of your plan's service area
When your employer group health plan or union coverage that supplements Original Medicare is ending
If you have a Medicare SELECT
When your Medigap Insurance company goes bankrupt, or your plan coverage ends through no fault of your own
If you leave a Medicare Advantage Plan or a Medigap plan because your insurance company didn't follow the rules or misled you
In a similar vein, you have Trial Rights 1 and 2:
If you enrolled in a Medicare Advantage plan or PACE (Program of All-inclusive Care for the Elderly) Initial Enrollment Period
If you dropped a Medigap plan to enroll in a Medicare Advantage plan (or Medicare SELECT plan) for the first time and, within the first year and decide to switch back
Note: There may be times when more than one of the situations above applies to you. When this happens, you can choose the guaranteed issue right that gives you the best choice.
If your insurance provider moves out of your service area, goes bankrupt, or discontinues your coverage for reasons that don't involve you, then:
You can choose a Medigap plan* sold by any insurance provider in your state
You can apply for a Medicare Supplement (Medigap) plan starting 60 days before your coverage ends until 63 days after your coverage has expired
To apply for a plan change with guaranteed issue rights, you must have the following information:
A disenrollment letter from your insurance company
The date your coverage ends
Your name (or the applicant's name) on the documentation
*Note: If you're eligible for Medicare after January 1, 2020, you cannot use guaranteed issue rights to enroll in Medicare Supplement Plan F.
If your employer group health plan or union coverage is ending, you can choose most Medigap plans* sold by any insurance provider in your state. Don't bank on your retirement plan or COBRA creditable coverage
The latest you may apply for a Medigap policy is 63 calendar days after one of the following three events:
The end of your coverage
The date of the notification informing you of the coverage termination (if received)
The date of a denied claim, if it was the only way to determine coverage termination
Note: Under certain conditions, your rights may be extended for 12 months (To learn more about this, talk with one of our advisors
When applying for a Medigap plan, keep a record of the following items:
Copies of any letters, notices, emails, or claim denials that include your name as evidence of your coverage termination
The postmarked envelope these documents came in as proof of the mailing date
You may need to submit some or all of these documents with your Medigap application to prove your guaranteed issue right.
If you lose your insurance coverage without canceling it or due to non-payment, it's considered involuntary, and you may be eligible for guaranteed issued rights.
However, if you choose to leave your group coverage voluntarily, keep the following information handy while applying for a Medigap plan:
The date the coverage ends
Documentation from your employer or carrier on their letterhead
Information about whether the coverage was primary or secondary
If an insurance provider misleads you or violates the regulations for Medicare Supplement plans, you may be eligible for guaranteed issue rights to enroll in a new plan.
To claim this, you may have to file a complaint with Medicare, and if your appeal is approved, you'll receive a guaranteed right to enroll in a new plan.
However, you must apply for your new Medigap plan within 63 days of your coverage ending.
As a federal program, Medicare allows states to impose additional rules as long as they adhere to the fundamental Medicare standards. Some states have implemented favorable regulations to assist seniors in adjusting their Medigap plans.
Here's a brief on different state-specific guaranteed issue rights.
Missouri — Once a year, during your policy anniversary, you can switch to a Medigap plan with similar or lesser benefits. This window of opportunity starts 30 days before your policy anniversary and ends 30 days after.
Washington — Has year-round guaranteed issue rights. You can switch to a similar or lower-benefit plan at any time.
California and Oregon — These states follow the Birthday Rule, which means that you can change your plan up to 30 days before and 30 days after your birthday each year.
Massachusetts — Has a state-specific Medigap Open Enrollment Window from February 1 to March 31 each year.
In some states, voluntarily terminating a group health plan does not grant guaranteed issue rights. But, some states allow the transition from employer coverage to Medigap using guaranteed issue rights. These states are:
Alaska
Arkansas
California
Colorado
Florida
Idaho
Illinois
Indiana
Iowa
Kansas
Louisiana
Maine
Missouri
Montana
Nevada
New Jersey
New Mexico
Ohio
Oklahoma
Pennsylvania
South Dakota
Texas
Virginia
West Virginia
Wisconsin
State-Specific Medicare Guaranteed Issue Rights for Group Termination
In addition to state-specific guaranteed issue rights, some states also provide continuous or annual open enrollment periods to help Medicare beneficiaries change their plans.
Some states allow you to change Medigap plans at any time or at specific times without undergoing medical underwriting. These states are:
Connecticut
New York
Vermont — only for Mutual of Omaha and UnitedHealthcare plans
Maine — Offers Open Enrollment annually in June. You can switch to a similar or lower-benefit plan without medical underwriting during this period
Guaranteed Issue Rights and Open Enrollment Window
If you're eligible for guaranteed issue rights, you'll need to provide documentation before switching plans.
For a Medigap-to-Medigap policy change, you'll need the following:
A copy of your current Medicare Supplement ID card with your current plan letter and your name
Proof of payment for the last three months that includes your full name
For a Medicare Advantage-to-Supplement policy change, you'll need the following:
Proof of disenrollment
The policy end date
Guaranteed Issue rights are important to the Medicare program, allowing you to access essential medical coverage during life events or circumstances that result in the loss of your existing plan.
However, Guaranteed Issue Rights vary among states, with some offering more favorable regulations for seniors and those with disabilities. Learn your state's regulations to make the most of the benefits provided by Medicare.
If you have any questions or need assistance in understanding your guaranteed issue rights, call us at 1-888-376-2028. Our team of experts
Does Medicare Cover Macular Degeneration?
Nov 30, 2022
Do All Hospitals Accept Medicare Advantage Plans?
Apr 11, 2023
14 Best Ways for Seniors to Stay Active in Nashville
Mar 10, 2023
Does Medicare cover Hyoscyamine?
Nov 30, 2022
What Is the Medicare Birthday Rule in Nevada?
Mar 28, 2023
Can I Change My Primary Care Provider with an Advantage Plan?
Aug 25, 2023
Does Medicare Cover Exercise Physiology?
Jan 11, 2023
How to Apply for Medicare?
Jul 15, 2022
Does Medicare Cover Cosmetic Surgery?
Nov 28, 2022
Does Medicare Cover Disposable Underwear?
Dec 8, 2022
Saving Money with Alternative Pharmacies & Discount Programs
Feb 1, 2024
Does Medicare Pay for Funeral Expenses?
Dec 6, 2022
How to Become a Medicare Agent
Aug 30, 2023
13 Best Ways for Seniors to Stay Active in Phoenix
Mar 6, 2023
Will Medicare Cover it?
Oct 3, 2023
Can I Use Medicare Part D at Any Pharmacy?
Aug 28, 2023
Does Your Plan Include A Free Gym Membership?
Jul 12, 2023
How Much Does a Medicare Coach Cost?
Mar 20, 2023
13 Best Ways for Seniors to Stay Active in Columbus
13 Best Ways for Seniors to Stay Active in Jacksonville
13 Best Ways for Seniors to Stay Active in Philadelphia
2024 Fair Square NPS Report
2025 Medicare Price Changes
Building the Future of Senior Healthcare
Can I Change Medicare Advantage Plans Any Time? | Medicare Plans
Can Medicare Advantage Plans be Used Out of State?
Can Medicare Help with the Cost of Tyrvaya?
Do I Need Medicare If My Spouse Has Insurance?
Do Medicare Supplement Plans Cover Dental and Vision?
Do You Need Medigap if You're Eligible for Both Medicare and Medicaid?
Does Medicare Cover a Spinal Cord Stimulator?
Does Medicare Cover Abortion Services?
Does Medicare Cover Air Purifiers?
Does Medicare Cover Breast Implant Removal?
Does Medicare Cover Cardiac Ablation?
Does Medicare Cover Cataract Surgery?
Does Medicare Cover Cervical Disc Replacement?
Does Medicare Cover Chiropractic Visits?
Does Medicare Cover Cold Laser Therapy (CLT)?
Does Medicare Cover Compounded Medications?
Does Medicare Cover Driving Evaluations?
Does Medicare Cover Flu Shots?
Does Medicare Cover Hepatitis C Treatment?
Does Medicare Cover Hoarding Cleanup?
Does Medicare Cover Hypnotherapy?
Does Medicare Cover Iovera Treatment?
Does Medicare Cover Kyphoplasty?
Does Medicare Cover Lipoma Removal?
Does Medicare Cover Mouth Guards for Sleep Apnea?
Does Medicare Cover Ofev?
Does Medicare Cover Piqray?
Does Medicare Cover Qutenza?
Does Medicare Cover Robotic Surgery?
Does Medicare Cover RSV Vaccines?
Does Medicare Cover Scleral Lenses?
Does Medicare Cover Tymlos?
Does Medicare Cover Wart Removal?
Does Medicare Pay for Allergy Shots?
Does Medicare Require a Referral for Audiology Exams?
Does Retiring at Age 62 Make Me Eligible for Medicare?
Explaining IRMAA on Medicare
Explaining the Different Enrollment Periods for Medicare
How Are Medicare Star Ratings Determined?
How Can I Get a Replacement Medicare Card?
How Do I Sign up for Medicare? A Simple How-To Guide For You
How Do Medicare Agents Get Paid?
How Does Medicare Pay for Emergency Room Visits?
How is Medicare Changing in 2025?
How Medicare Costs Can Pile Up
How Often Can I Change Medicare Plans?
How Your Employer Insurance and Medicare Work Together
Is Balloon Sinuplasty Covered by Medicare?
Is Gainswave Covered by Medicare?
Is the Shingles Vaccine Covered by Medicare?
Is Vitrectomy Surgery Covered by Medicare?
Medicare & Ozempic
Medicare Advantage MSA Plans
Medicare Consulting Services
Medicare Guaranteed Issue Rights by State
Medicare Savings Programs in Kansas
Medicare Supplement Plans for Low-Income Seniors
Plan G vs. Plan N
Top 10 Physical Therapy Clinics in San Diego
What is a Medicare Beneficiary Ombudsman?
What Is a Medicare Supplement SELECT Plan?
What Is Medical Underwriting for Medigap?
What People Don't Realize About Medicare
What You Need to Know About Creditable Coverage
When Can You Change Medicare Supplement Plans?
Will Medicare Cover Dental Implants?
Get the Fair Square Bulletin
Medicare savings tips, helpful guides, and more.
Virgil Insurance Agency, LLC (DBA Fair Square Medicare) and www.fairsquaremedicare.com are privately owned and operated by Help Button Inc. Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. This is a solicitation of insurance. A licensed agent/producer may contact you. Medicare Supplement insurance is available to those age 65 and older enrolled in Medicare Parts A and B and, in some states, to those under age 65 eligible for Medicare due to disability or End-Stage Renal disease. Virgil Insurance Agency is a licensed and certified representative of Medicare Advantage HMO, HMO SNP, PPO, PPO SNP and PFFS organizations and stand-alone PDP prescription drug plans. Each of the organizations we represent has a Medicare contract. Enrollment in any plan depends on contract renewal. The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, or sex. Plan availability varies by region and state. For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov. © 2025 Help Button Inc
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
MULTIPLAN_FairSquareMedicare_01062022_M