Understanding the Purchase of Medicare Supplement Coverage

There are a number of situations when you can buy Medicare supplement coverage after the open enrollment period. Three of the most common situations are below:

Situation 1

Initially you joined a Medicare + Choice plan, such as a Medicare HMO, when you first signed up for Medicare at age 65.

Like many Medicare HMO members, you are disappointed and want to leave the Medicare HMO within one year of joining. You now want to return to the Original Medicare plan and to purchase a Medicare Supplement Insurance policy.

Government Regulations that Apply for this Situation:

You have the right to buy any supplemental Medicare coverage available in the concerned state. You must apply for the new coverage within 63 days once your present coverage expires.

If you're still in your Medicare supplement open enrollment period after you leave the Medicare plan, you may have more than 63 calendar days to buy a Medicare supplement coverage policy.

The Insurer can't deny you supplemental Medicare coverage or place conditions on that Medicare supplement coverage, such as a waiting period. You must be covered for all pre existing conditions. The rate that you pay cannot lead to paying more because of pre-existing health problems.

Situation 2
You want to sign up for the Original Medicare Plan and buy Medicare Supplemental coverage because you lost your:

•Current Medicare + Choice plan, such as a Medicare HMO or Medicare Advantage Plan
•Retiree Group Health Insurance,
•Medicare Supplement Coverage, or
•Medigap Policy

You lost your health insurance coverage or policy because:

•Your Medicare supplement coverage provider dropped out of the Medicare program or stopped giving care in your area; or
•You moved outside your plan's service coverage area; or
•You left the Medicare plan because the plan failed to meet its contractual obligations to you; or
•Your retiree group health insurance, which was providing your Medicare supplemental coverage , ended; or
•Your Medicare supplement company ended your Medicare supplement coverage or Medicare SELECT plan. For example, the Medicare insurer went out of business.

Government Regulations that Apply for this Situation:

You have the right to buy secondary Medicare supplement coverage A, C, B, or F that is available in the state where you live. Provided that the person applies for the insurance in a time period of sixty three days after your health Medicare supplement coverage ends.

The Medicare supplement coverage company can't deny you coverage or place conditions on that policy, such as a waiting period. You must be covered for all pre existing conditions. The rate that you pay cannot be more because of pre-existing health problems.

If you are under 65 on Medicare disability or have kidney failure on Medicare, you have the right to buy any of the plans sold in your state to those under 65.

Situation 3

You were in the original Medicare coverage plan and had a Medicare supplemental policy. You dropped your supplemental Medicare coverage policy to join a Medicare HMO, and the three isques apply to you:

1. This is the first time you have ever been in a Medicare HMO plan
2. You've been in the plan or had the policy for less than a year.
3. You now want to sign back up with the original Medicare plan and to purchase Medicare supplement coverage.

Government Regulations that Apply for this Situation:

You have the right to return to your former supplemental Medicare coverage, if it's still available, and with the present insurance company. The insured person must file application for new coverage within 63 days as the present coverage expires.

If your former supplement Medicare coverage is no longer available, you have the right to Medicare Supplement InsurancePlan A, C, B, or F that is sold in your state.

The Medicare coverage company can't deny you coverage or place conditions on that policy, such as a waiting period. You must be covered for all pre existing conditions. The rate that you pay cannot be more because of pre-existing health problems.

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Read Comparsion between Medicare Supplement Insurance Plans