What Does Guaranteed Issue Mean Relating to a Medicare Supplement Policy?

Medicare Supplement Guaranteed Issue

If one of the following circumstances apply, an individual is guaranteed coverage under

plans A, B, C, F, F, K, and L:

a.) Your Medicare Advantage Plan coverage ends because the plan is leaving the Medicare program or stops giving care in your area. You must apply for other coverage between the date you receive notice your coverage will be ending, and no later than 63 calendar days after your coverage ends.

b.) Your Medicare

Supplement policy terminates because the insurance carrier becomes insolvent.

c.) You move out of the service area of your Medicare Advantage Plan, Medicare SELECT policy or PACE program.

d.) You leave the health plan because it failed to meet its contract obligations to you (Example: the marketing materials were misleading, or quality standards were not met).

e.) You dropped your Medicare Supplement policy to join a Medicare managed care plan (HMO), Preferred Provider Organization (PPO), Private Fee-for-Service plan(PFFS), or PACE program and then leave the plan within one year after joining. You must go back to your former Medicare Supplement policy with the same company you had before you


in order to get a guaranteed issue policy. If the former Medicare Supplement policy is not available, then you can get Plans A, B, C, F, K, or L from any company on a guaranteed issue basis. The individual must apply no later than 63 calendar days from the date the coverage ends.

Please note: If you joined a Medicare Advantage Plan (like a Medicare HMO, PPO, or PFFS plan) or PACE program when you first became eligible for Medicare Part A at age 65 and you leave the plan within one year of joining, you are eligible for any Medicare Supplement policy from any company on a guaranteed issue basis.

Can my Medicare Supplement policy be cancelled by the insurance company?

All Medicare Supplement Policies sold in the State of Florida must be “Guaranteed Renewable.” Most state laws prohibit companies from canceling these policies except for nonpayment of premium or for material misrepresentation, such as incomplete or incorrect information on the original application.

I purchased a Medicare Supplement policy and do not wish to keep it. Can I return it to the company and get a refund?

A 30-day free-look period is provided on all Medicare Supplement plans. The free-look provision starts from the day the policy is delivered. A Medicare Supplement policy issued or delivered in Florida must contain a provision which allows the insured to return the policy or certificate within 30 days and receive a full refund. We recommend returning the policy to the company in a manner in which delivery can be verified.