How to Protect Yourself from Being Denied Coverage or Overcharged for Your Medigap Policy: Insights from a Supplemental Insurance Agency in Crown Point, Indiana

Many individuals who are 65 years or older sign up for Medicare with the expectation that they will spend less money out of their own pockets on healthcare. But after enrolling in Medicare, individuals are still required to pay deductibles and copayments for hospital stays, doctor appointments, and other healthcare expenses. If you sign up for traditional Medicare, you have the option to enroll in a Medicare supplement plan (also known as Medigap) from a private insurer to help fill in the gaps.

However, there is a caveat — if you do not get the coverage in time, insurers in most states have the right to refuse you or charge you more because of your preexisting conditions. This limitation no longer applies to other types of health insurance. To help you avoid running into this situation, this supplemental insurance agency in Crown Point, Indiana is going to discuss everything you’ll need to know below.

Sign up at the right time.

During the following times, you can buy a Medigap policy regardless of whether you have any preexisting conditions (this is known as a guaranteed issue right):

  • For six months, starting the month you enroll in Medicare Part B when you are 65 or older. You will get the best price when enrolling in a supplemental health insurance plan in Crown Point, Indiana based on your age, sex, and smoking status.
  • Up to 63 days after losing job-based health insurance secondary to Medicare. If you or your spouse work for a firm with fewer than 20 employees and are 65 or older, your insurance is generally considered secondary to Medicare.
  • During a trial enrollment period. If you choose a Medicare Advantage plan when you initially enroll in Medicare, you have up to 12 months to drop the plan, switch to the original Medicare, and get any Medigap policy available in your region.
  • If you dropped a Medigap policy to enroll in Medicare Advantage and now wish to return to original Medicare. You have up to a year to get the same Medigap plan. ​
  • If you leave your Medicare Advantage plan’s service area or the plan goes out of business.

You can check out the Centers for Medicare & Medicaid Services (CMS) Guide to Choosing a Medigap Policy for more information on when insurers cannot charge you more or reject you because of your health. ​Or, if you would like to speak to an expert in-person, you can always get in touch with your local supplemental insurance agency in Crown Point, Indiana.

Find an insurer who will cover your medical condition.

If you apply for a Medigap plan without a guaranteed issue right, you will likely be asked questions about your health. Insurers rarely request your medical records, but they do inquire about your prescription medications.

Having one of these medical conditions in the last two years can result in a higher Medigap premium, depending on the insurer:

  • Arterial thrombosis
  • Atrial fibrillation
  • Cancer
  • Cardiomyopathy 
  • Chronic kidney disease
  • Chronic obstructive pulmonary disease
  • Congestive heart failure
  • Multiple sclerosis
  • Rheumatoid arthritis

Insurers often reject people with chronic obstructive pulmonary disease, lupus, Parkinson’s disease, or who have recently been diagnosed with cancer. Other medical conditions may be acceptable, such as high blood pressure, diabetes, and high cholesterol — however, you may be required to pay higher premiums.

You may also be asked whether a qualified doctor has advised you that you may need any of the following procedures:

  • Replacement arthroplasty or joint replacement surgery
  • Organ transplant
  • Cancer surgery
  • Back or spine surgery
  • Heart or vascular surgery

Some insurers may deny coverage if you have been hospitalized in the last 90 days or live in a nursing home. The timing and nature of your medical condition are critical. If you were recently diagnosed with cancer or underwent surgery, you may still be able to buy a plan. Your local supplemental insurance agency in Crown Point, Indiana will be happy to discuss your situation and help you find the right coverage.

Looking for a Supplemental Insurance Agency in Crown Point, Indiana?

Are you interested in enrolling in a Medigap plan? If so, and if you’re looking for the top-rated supplemental insurance agency in Crown Point, Indiana, look no further than the experts at Senior Care Insurance Services (SCIS). Our qualified and experienced insurance agents will be happy to assist you in deciding which policy best matches your needs and financial situation. Contact us today to request a free quote.


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