How to qualify for a Medicare supplement without medical underwriting

Dear Toni: I have decided to retire when I turn 65 in February and need to enroll in Medicare Parts A and B. My husband, Harry, is 74, and he enrolled in Parts A and B when he turned 65, remaining on my employer benefits with health issues.

The office manager for his primary doctor expressed concerns because of my husband’s serious lung problems, which will require surgery in 2026. She suggested that Harry apply for a Medicare supplement.

Please explain how we can enroll in a Medicare supplement plan when I retire. — Carolyn, Omaha, Neb.

Dear Carolyn: A Medicare supplement, or Medigap, plan is a private insurance policy that covers costs not picked up by original Medicare.

The good news is, Medicare has special rules for employees, and their spouses, who are covered by an employer’s group health insurance plan.

Because he is leaving your employer health plan, Harry qualifies for the 63-day guaranteed issue period to apply for a Medicare supplement without medical underwriting.

During this period, insurers cannot deny you coverage or charge you a higher premium based on pre-existing health conditions. Harry will need a termination letter from your company benefit plan to prove that he is in a guaranteed issue period.

With a guaranteed issue plan, an insurance company:

■ Must sell you a Medicare supplement policy. You have the right to buy supplement plan A, B, C, F, K or L. Harry is not eligible for Plan G with as a guaranteed issue policy since his Medicare Part A began before Jan. 1, 2020. Those whose Part A began after Jan. 1, 2020, are eligible for Plan G, but not Plans C or F, as a guaranteed issue policy.

■ Must cover all your pre-existing health conditions.

■ Cannot charge the insured more for a Medicare supplement policy, regardless of past or present health problems.

Carolyn, since you are turning 65 in February, you’ll have a less stressful enrollment process than Harry because you are in your Medicare supplement open enrollment period.

The 2026 “Medicare & You” handbook says, “The best time to purchase a Medicare Supplement policy is during your Medigap Open Enrollment Period. This 6-month period begins the first month you have Medicare Part B (Medical Insurance), and you’re 65 or older.”

Enrolling in Medicare Part B the correct way, when you or your spouse is working full time with employer benefits, is extremely important. Not only do you want to avoid a Medicare Part B penalty, but you want to be able to enroll in a Medicare supplement while avoiding medical underwriting.

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.