insurance

How Preexisting Conditions Can Affect Medigap Insurance

In many cases, insurers can take preexisting conditions into account when deciding whether to sell you a medigap policy and what to charge you.

Question: Is it true that an insurance company can factor in preexisting conditions when deciding whether to offer you a medigap policy or when setting the premiums?

Answer: That’s correct. Many people don’t realize that even though preexisting conditions can’t affect your ability to get other types of health insurance, the rules are different for medigap. You can pick any medigap plan available in your area within six months after you initially sign up for Medicare Part B. But after that, medigap insurers in almost all states can reject you or charge more based on your health. This can make it difficult if you’d like to switch to another insurer with better medigap rates or if you had a Medicare Advantage plan for more than a year and want traditional Medicare and a medigap policy instead.

There are a few exceptions. A few states—including Connecticut, Massachusetts and New York—have special rules that let residents switch medigap plans regardless of preexisting conditions. Other states permit you to change plans at certain times. For example, Californians may select a different medigap plan that has the same or fewer benefits if they do it within 30 days after their birthday each year. You may also buy a medigap policy without concern about preexisting conditions if you move out of your Medicare Advantage plan’s service area or change your mind within 12 months of signing up for Medicare Advantage at age 65. For more information see Medicare.gov’s When Can I Buy Medigap?

Also, your insurer may let you switch to a less-comprehensive policy regardless of your health (such as switching from a Plan F to a high-deductible Plan F, for example). See the Medicare Rights Center’s list of what each type of medigap policy covers.

And if you’re healthy, you may still be able to qualify for a new medigap policy, especially if you’re in your mid to late sixties. You don’t need to wait until any specific time of year to apply for a new medigap policy because there is no annual open-enrollment period.

For more information about your state’s rules, see your state insurance department website. You can find links at www.naic.org/map. Most have consumer guides that list medigap prices and provide information for seniors searching for a plan. Your State Health Insurance Assistance Program can also help. See www.shiptacenter.org for links.

Most Popular

Election 2020: Joe Biden's Tax Plans
taxes

Election 2020: Joe Biden's Tax Plans

With the economy still in trouble, tax policy takes on added importance in the 2020 election. So, let's take a look at what Joe Biden wants to do abou…
October 22, 2020
How to Be Happy (Not Bored!) in Retirement – Starting Today
happy retirement

How to Be Happy (Not Bored!) in Retirement – Starting Today

Here are 12 ways to prepare now for retirement so that you’ll be happy, active, fulfilled and never, ever bored.
October 21, 2020
2 Credit Card Gotchas to Watch Out For
credit cards

2 Credit Card Gotchas to Watch Out For

After an infuriating wake-up call with her own credit card company, one financial services consultant wants consumers to know something: It’s smart to…
October 20, 2020

Recommended

How Much Insurance Should You Get? A Lawyer’s Advice
insurance

How Much Insurance Should You Get? A Lawyer’s Advice

The advice to “Only pay for what you need” sounds good. But when it comes to home, auto and business insurance coverage, four guidelines could help de…
October 12, 2020
10 Worst Things to Keep in Your Wallet
Scams

10 Worst Things to Keep in Your Wallet

Storing your passport book or card, a spare key, or any of these other important items in your wallet leaves you open to identity theft -- or worse.
October 9, 2020
7 Things Medicare Doesn’t Cover
Healthy Living on a Budget

7 Things Medicare Doesn’t Cover

Medicare Part A and Part B leave some pretty significant gaps in your health-care coverage. Here's a closer look at what isn't covered by Medicare.
October 1, 2020
11 Costly Medicare Mistakes You Should Avoid Making
Medicare

11 Costly Medicare Mistakes You Should Avoid Making

If you don't make the right choices to fill in the health coverage gaps, you could end up with high Medicare premiums and big out-of-pocket costs.
October 1, 2020