Applying for a Medicare supplement at right time is essential
Dear Toni: I retired last June when my employer offered a great retirement package with COBRA at no cost for me and my husband for 18 months, which ends Dec. 31. I am 62 and will not be enrolling in Medicare for a while. My husband, John, is 72, and he enrolled in Medicare Part B in June 2022, when our COBRA began, because he was having heart surgery after a heart attack. He enrolled in Medicare Part A in 2018.
John needs help applying for a Medicare supplement; he is being denied for health issues because he must answer underwriting questions. Why is it so complicated to apply for a Medicare supplement? What did we do wrong when I retired? — Sarah, Pearland, Texas
Dear Sarah: There is a Medicare supplement rule that can keep John from having to answer underwriting questions despite his heart issues.
Because John is losing his COBRA “company” benefits, he qualifies for the 63-day guaranteed issue period to apply for a Medicare supplement/Medigap plan without medical underwriting. He will need your company benefits termination letter to prove that he is in a guaranteed issue period. Isn’t it amazing how complicated Medicare rules can be?
The “Medicare & You” handbook explains Medigap guaranteed issue rights. Because John has “original Medicare and an employer group health plan (including retiree or COBRA coverage) that pays after Medicare pays and that the plan is ending,” he is eligible for a Medicare supplement without medical underwriting.
With guaranteed issue, an insurance company:
■ Must sell you a Medigap/Medicare supplement policy. “You have the right to buy Medigap/Medicare supplement plan A, B, C, F, G, K or L that’s sold in your state by any insurance company.” John is eligible for Plan F or C with guaranteed issue rights as his Medicare Part A began in 2018. (Plans F and C are available only to those who were eligible for Part A before Jan. 1, 2020.) Those whose Part A began after Jan. 1, 2020, are eligible for Plan G. Also, there are only 63 days to apply for a Medicare supplement from the date the coverage ends. Attach a copy of the termination letter to the application.
■ Must cover all your pre-existing health conditions.
■ Cannot charge you more for a Medicare supplement/Medigap policy, regardless of past or present health problems.
Toni King is an author and columnist on Medicare and health insurance issues. If you have a Medicare question, email info@tonisays.com or call 832-519-8664.
