Is it possible to get a Medicare Supplement plan without underwriting?
Asked by: Augustus Metz Jr. | Last update: February 26, 2025Score: 4.7/5 (50 votes)
Do Medicare Supplement plans require medical underwriting?
Enrolling clients into Medicare Supplements when they turn 65 isn't difficult, since those aging into Medicare have the opportunity to sign up for any Medicare Supplement regardless of health. But this isn't always the case. Sometimes a client will have to pass underwriting, a process where health matters.
What states allow you to change Medicare Supplement plans without underwriting?
Medigap state variation
Five states (California, Idaho, Illinois, Nevada, and Oregon) have “birthday rules” that allow Medigap enrollees a 30-day window following their birthday each year when they can switch, without medical underwriting, to another Medigap plan with the same or lesser benefits.
Is it possible to get a Medicare Advantage plan without medical underwriting?
No, there is no underwriting for Medicare Advantage.
Can Medicare Supplement plans deny coverage for preexisting conditions?
Do Medicare Supplement insurance plans cover preexisting conditions? Yes. However, a Medigap insurance company can refuse to cover pre‑existing conditions for up to 6 months after enrollment. This is called a “pre‑existing condition waiting period.” After 6 months, the Medigap policy will cover those conditions.
Here's How Much We Paid With Medicare | Medicare Supplement vs Advantage
What is the term for a Medicare Supplement plan that does not require underwriting?
Federal law requires Medigap insurers to issue Medigap policies without medical underwriting during a one-time, six-month Medigap open enrollment period for beneficiaries ages 65 and older when first enrolling in Medicare Part B, and for certain qualifying events, such as during a Medicare Advantage trial period.
Can you get supplemental insurance with a pre-existing condition?
Yes. Under the Affordable Care Act, health insurance companies can't refuse to cover you or charge you more just because you have a “pre-existing condition” — that is, a health problem you had before the date that new health coverage starts.
Can you be denied a Medicare Supplement plan?
At other times, insurance companies may refuse to sell you a policy. If you have or had health problems, you may not be able to buy the Medigap plan of your choice unless you are in open enrollment or a guarantee-issue period.
Why are hospitals refusing Medicare Advantage plans?
Among the most commonly cited reasons are excessive prior authorization denial rates and slow payments from insurers. In 2023, Becker's began reporting on hospitals and health systems nationwide that dropped some or all of their Medicare Advantage contracts.
What is the best supplemental insurance for Medicare?
- Best for extra plan benefits: Humana.
- Best for straightforward coverage: State Farm.
- Best for extensive medical care coverage: AARP by UnitedHealthcare.
- Best for a range of Medigap plans: Blue Cross Blue Shield.
How can we avoid Medigap underwriting?
You can enroll in a Medigap plan without going through medical underwriting (in other words, without having to answer any medical questions) if you enrolled in a Medicare Advantage (MA) plan when you first became eligible for Medicare at age 65 and then decided a Medicare Advantage plan was not for you.
Do Medicare Supplement plans require prior authorization?
Broadly speaking, Medicare Supplement plans provide better access to care. By significantly reducing out-of-pocket expenses, they ensure the cost of services isn't a barrier to care. They also don't limit your access through provider networks and prior authorization requirements.
Which states have guaranteed issues for Medigap?
State laws can provide further protections, but only four states— Connecticut, Massachusetts, Maine, and New York—require either continuous or annual guaranteed issue protections for Medigap for all beneficiaries in traditional Medicare ages 65 and older, regardless of their medical history.
Can I change Medicare Supplement companies without underwriting?
Yes, a person can change Medigap policies without medical underwriting if they are within the 6-month Medigap open enrollment period. They can also do so if they are eligible under a specific situation or guaranteed issue right.
Can you use COBRA as a supplement to Medicare?
If you get COBRA first and then become eligible for Medicare, when you turn 65, COBRA will cease providing primary insurance coverage to you. Medicare will become primary, and if you can keep COBRA, it will become your secondary insurer.
Can I be turned down for a Medigap plan?
Outside of your Medigap Open Enrollment Period: You may have to pay more for a policy. Fewer policy options may be available to you. The insurance company is allowed to deny you a policy if you don't meet their medical underwriting requirements.
Why are seniors losing Medicare Advantage plans?
Medicare vs Privatized Medicare Advantage
Beneficiaries are tossed aside because they live in an unprofitable market for their insurer or because they are actually using the insurance they signed up for to access services.
Is Mayo Clinic no longer accepting Medicare Advantage plans?
We do not accept noncontracted Medicare Advantage Plans.
Why are hospitals dropping UnitedHealthcare?
Among the most commonly cited reasons are excessive prior authorization denial rates and slow payments from insurers. Some systems have noted that most MA carriers have faced allegations of billing fraud from the federal government and are being probed by lawmakers over their high denial rates.
What is the downside to Medicare Supplement plans?
There are a couple of cons to consider before choosing a Medigap plan: Premiums: Medigap premiums can be pricey. Coverage: Medicare Supplement plans don't cover everything, so you'd still have to pay out of pocket for things like dental care, vision care and long-term care.
Can you get Medicare supplemental insurance with pre-existing conditions?
During your Medicare Supplement Open Enrollment Period, an insurance company can't refuse to sell you a policy based on your pre-existing condition and it can't charge you more than someone without health problems. After your Open Enrollment Period ends, you may be subject to medical underwriting.
Can a doctor refuse a Medicare Supplement?
The short answer is “No”. However, if a doctor accepts Medicare itself, which is your primary coverage, then they will also accept your Medigap plan, regardless of what company sold you the plan or which Medigap plan you have. The key thing to remember is that Medigap plans “follow” Medicare.
What pre-existing conditions are not covered?
Is there health insurance for pre-existing conditions? Choosing a health plan is no longer based on the concept of a pre-existing condition. A health insurer cannot deny you coverage or raise rates for plans if you have a medical condition at the time of enrollment.
What is the waiting period for Medicare Supplement?
You can buy a Medigap policy once you sign up for Medicare.
This is the 6-month period that starts the first day of the month you're 65 or older and signed up for Part B. After this period, your options to buy a Medigap policy may be limited and the policy may cost more.
How far back is a pre-existing condition?
A pre-existing medical condition is a disease, illness or injury for which you have received medication, advice or treatment or had any symptoms (whether the condition has been diagnosed or not) in the five years before your joining date. Health insurance doesn't usually cover 'pre-existing conditions'.