Medically Underwritten Medigap Coverage

Medically Underwritten Medigap Coverage

Most people that enroll in Medicare and Medicare supplements will do in a guaranteed issue manner. This means that they will qualify under one of the many reason for guaranteed issue enrollment regardless of their health. Turning 65 with a new Part B or leaving group health insurance are the two most common of these but you can find the entire list at our Guaranteed Issue Medigap Reasons article. There’s a great deal of coverage and importance covering these windows and for good reason but some Medicare elligble people assume that they are the only time you can enroll in a Medicare supplement plan. That’s not the case depending on your health. Let’s take a look at medically underwritten Medigap underwriting.

Some people for various reasons choose to delay enrollment in Medicare or a Medicare supplement. They may have Part A and B, be over age 65 (not on group insurance) and simply not enroll in a Medicare supplement plan within 6 months from when they’re eligible to. Keep in mind that Part B is required to qualify for a Medicare supplement plan and it is both optional and generally requires monthly premium depending on a person’s income. A percentage of these people will choose not to enroll in Medigap plan right away mostly due to the additional cost. What if 2 years later, that same person decides that they want additional protection and would like to apply for a Medicare supplement plan? That’s when the enrollment becomes medically underwritten which means that the carrier can decline coverage due to health. This may sound dire especially if over the age of 65 when health issues might be more prevalent but there is still hope.

Although health history/status questions are asked on the application which generally included medication usage, the questions generally pertain to much more serious issues. We can send you an application for one of the major carriers in your State if you like after requesting your quote. Your licensed agent assigned to help you with questions after the quote is received will send you the application upon request. Take a look at the health history section. You’ll see that even with an average history of health issues, it can be possible to still answer “no” to the health history section as many of the questions deal with very serious and significant health concerns such as longer duration hospitalizations, heart disease, dialysis, etc. In most cases, our applicants were able to qualify based on their health status including medications, which are pretty common over age 65. It’s important to answer these questions honestly and accurately to make sure you do not have issues down the line. There’s no advantage to withholding information only to have it come back up when you have claims on the policy.

Here’s the issue. Many people who have opted not to enroll in a Medicare supplement plan due to cost would continue along this path unless something big comes up. That’s where we can have a problem. Keep in mind that the whole reason to get a Medigap plan is to cover the 20% coinsurance that Medicare alone doesn’t pick up. 20% of $100K can be $20K and that’s a lot of money. Considering that Medigap F plans run between $100-200 monthly depending on your age, it’s generally not prudent to take on this type of exposure, especially in today’s world of ever-increasing health care costs, for that level of savings. The risk is too great and owing to the age demographic, increasing with each year of a person’s life over age 65. We still can try to qualify for a Medicare supplement plan outside of guaranteed issue windows but the better course is to avoid this altogether by signing up when you’re guaranteed to be accepted.

An article by Dennis Jarvis

Published at: https://www.isnare.com/?aid=1576688&ca=Finances