Losing a Medicare Advantage Plan Can Trigger Guaranteed Medigap Access

If your Medicare Advantage plan is ending, you have a limited window to buy a Medicare Supplement, or Medigap, policy without being denied or charged more because of your health. To use that protection, switch back to Original Medicare instead of enrolling in another Advantage plan, and apply before your current coverage ends so you do not have a break in coverage.

Your plan must send a non-renewal notice at least 90 days before the coverage ends. In one major insurer's investor update, the company said its planned exits from Medicare Advantage would affect about 600,000 members.

Normally, once your one-time Medigap open enrollment period has passed, insurers can review your health history, reject your application, or charge a higher premium. When an Advantage plan leaves Medicare or withdraws from your service area, that changes. If your plan exits your area or you move outside it, insurers must sell you a policy, cover pre-existing conditions, and cannot price the policy higher because of your health.

The guaranteed right applies to Plan G if you first became eligible for Medicare in 2020 or later, and to Plan F if you became eligible earlier. It does not apply to Plan N. To take advantage of the protection:

• Keep the notice and the postmarked envelope as proof of your right.
• Apply during the 60 days before your plan ends and ask for coverage to begin immediately after your old plan expires.
• Choose a stand-alone Part D drug plan during open enrollment so prescription coverage also begins at the same time.

This right remains available for 63 days after your old plan ends, but waiting too long can leave you uninsured for a period. If you are leaving Medicare Advantage by choice, get approved for Medigap before dropping your plan.

One place to begin is Mutual of Omaha. AM Best rates Mutual of Omaha Insurance Company A+ (Superior). Its online quoting tool uses your ZIP code, birth date, and sex to price Plan G, and it does not require contact information. You can also apply online. Couples leaving the same plan may be able to save through a household discount where available, although the amount and eligibility rules vary by state. A review of Mutual of Omaha includes sample quotes from three cities.

Request a quote as soon as your notice arrives, and because every Plan G offers the same benefits, compare it with the Medicare.gov listings for your ZIP code. If you miss this guaranteed right, a later switch will usually require you to answer health questions in most states.