Events That Guarantee Your Right To Buy
Medicare Supplement Insurance
Medicare Supplement Open Enrollment Guarantees
You have a six-month open enrollment period when you are enrolled in Medicare
Part B for the first time at age 65 or older. The six-month period begins the date
your Medicare Part B begins. During your open enrollment period:
You cannot be turned down for any plan being sold in Iowa:
-
Age 65 prior to January 1, 2020: Plan A, B, C, D, F, G, K, L, M or N
- Age 65 on or after January 1, 2020: Plan A, B, D, G, K, L, M or N
You cannot be charged a higher premium based on your health.
You will not have a waiting period before benefits are paid for pre-existing
health conditions IF you had previous health insurance coverage, AND you
apply within 63 days of the end of previous health insurance, AND you were
covered for at least 6 months under that health plan.
Special Event Enrollment Guarantees
Events That Trigger A
Guarantee Issue Opportunity
Enrollment Options
Available For 63 Days Only
1.
You are covered by an employer group health benefit
plan which pays benefits after Medicare pays, and the
plan stops providing some or all health benefits. This
includes retiree or COBRA coverage. These situations
do not trigger this benefit: increase in premium; loss of
Medicaid; choosing to leave your employer plan; your
spouse losing coverage because of your decision to
terminate your employer coverage; or reaching your
annual limit or lifetime maximum.
You must be allowed to enroll
in any Medicare supplement or
Medicare Select Plan listed
below:
Age 65, disabled or ESRD*
Medicare before January 1,
2020:
Plan A, B, C, F (including a
high deductible Plan F), K or L
from ANY COMPANY selling
these plans in Iowa.
Age 65, disabled or ESRD*
Medicare on or after January
1, 2020:
Plan A, B, D, G (including a
high deductible Plan G), K or L
from ANY COMPANY selling
these plans in Iowa.
If you are a Medicare
beneficiary under age 65, you
will be limited to buying only
from companies selling to those
under 65.
2.
You are enrolled in a Medicare Advantage or Medicare
Cost or Medicare Select plan or Programs of All-
Inclusive Care for the Elderly (PACE) provider and
you disenroll because
You move from the service area or
The plan stops providing Medicare services or
The plan seriously violates the contract or
misrepresents the plan during marketing.
3.
You are enrolled under a Medicare Supplement policy
and it ends because
The company is insolvent or bankrupt or
Coverage is involuntarily terminated or
The plan seriously violates the contract or
misrepresents the plan during marketing.
Events That Trigger A
Guarantee Issue Opportunity
Enrollment Options
Available For 63 Days Only
4.
You are enrolled in a Medicare
supplement policy
And you stop the Medicare supplement
and enroll in a Medicare Advantage,
Medicare Cost, or Medicare Select plan
or PACE provider for the first time,
Then you disenroll from the new plan or
program within the first 12 months.
You must be allowed to
Re-enroll in the Medicare supplement policy
you were most recently enrolled in if it is
available from the same insurance company,**
or if not available,
Age 65, disabled or ESRD* Medicare before
January 1, 2020: Enroll in any Medicare
supplement Plan A, B, C, F, K or L (including
Medicare Select or high deductible choices)
sold in Iowa.
Age 65, disabled or ESRD* Medicare on or
after January 1, 2020: Enroll in any
Medicare supplement Plan A, B, D, G, K or L
(including Medicare Select or high deductible
choices) sold in Iowa.
If you are under age 65, you can buy only from
companies selling to those under 65.
5.
You enroll in a Medicare Advantage plan or
PACE, at age 65,*** during your seven
month Initial Enrollment Period (IEP) for
Part B and disenroll within 12 months.
Individuals enrolled in Medicare Part B
prior to age 65 are not eligible for this GI
event when they turn 65.
This includes individuals who enroll in
employer-sponsored Medicare
Advantage plans.
Age 65 before January 1, 2020: You must be
allowed to enroll in ANY Medicare
supplement plan, A, B, C, D, F, G, K, L, M or
N sold in Iowa.
Age 65 after January 1, 2020: You must be
allowed to enroll in ANY Medicare
supplement plan, A, B, D, G, K, L, M or N
sold in Iowa.
Includes Medicare Select or high deductible
choices.
*ESRD is abbreviation for End Stage Renal Disease
**This option does not apply to employer retiree health plans. If you give up your employer retiree
plan to try a Medicare Advantage plan, you may not get your employer retiree plan back later.
***There is one exception to this if you take Part B for the first time after age 65. Call
SHIIP for details.
Protections With These Special Events:
If you apply for your new Medicare supplement plan within 63 days of the end of previous
coverage:
Companies cannot turn you down because of existing health conditions.
Companies cannot charge you higher premiums because of existing health conditions.
You will not have a waiting period before benefits are paid for existing health conditions.
If you have questions about Medicare or other senior health insurance issues,
contact SHIIP for assistance. Toll-free: 1-800-351-4664 (TTY 1-800-735-2942)
October 2020
This publication has been created or produced by the Iowa Senior Health Insurance Information Program with financial assistance, in whole or in
part by grant numbers 90SAPG0070 and 90MPPG0046 from the U.S. Administration for Community Living, Department of Health and Human
Services, Washington, D.C. 20201
