Home / Medigap Guaranteed Issue Rights: The Federal Situations and Deadlines
Medigap Guaranteed Issue Rights: The Federal Situations and Deadlines
In these situations an insurer must sell you a Medigap policy, must cover your pre-existing conditions, and cannot charge you more because of your health. States may add more.
What "guaranteed issue" means
Medicare calls these your "guaranteed issue rights" or "Medigap protections." In these situations, an insurance company must sell you a Medigap policy, must cover all your pre-existing health conditions, and cannot charge you more for a Medigap policy because of past or present health problems. Guaranteed issue periods are time-limited.
1. Medigap Open Enrollment Period (federal)
A one-time 6-month period that starts the first month you have Medicare Part B and are 65 or older. An insurer cannot refuse to sell you any Medigap policy it offers and cannot use medical underwriting. After it ends you may pay more, have fewer choices, or be denied. It does not repeat every year.
2. Medicare Advantage trial rights
- First Medicare Advantage plan at 65. If you joined a Medicare Advantage plan (or PACE) when first eligible for Medicare Part A at 65 and decide within the first year to switch to Original Medicare, you can buy certain Medigap policies sold in your state. Apply up to 60 days before your coverage ends, and no more than 63 days after it ends.
- You dropped Medigap to try Medicare Advantage. If you dropped a Medigap policy to join Medicare Advantage (or to switch to a Medicare SELECT policy) for the first time and have been in the plan less than a year, you can repurchase the Medigap policy. If the same company no longer sells it, you can buy certain other policies, depending on state law.
Medicare notes that some states give additional time or special rights. Check with your State Insurance Department.
3. Your Medicare Advantage plan changes or ends
- Your plan discontinues coverage in your area.
- You move out of the plan's service area and can no longer get coverage from its providers.
- Your plan's contract with Medicare is terminated.
- Your plan commits fraud.
Federal rules generally give you 63 days to apply for a policy in these situations. Medicare's guide says to apply up to 60 days before the date your coverage ends if you are choosing to leave, or by the date in your plan's termination notice, and no more than 63 days after your coverage ends. Medigap policies cannot start until your Medicare Advantage coverage ends.
4. Employer retiree coverage ends
You have a federally guaranteed right if your employer cancels your retiree coverage. You do not have a federal right if your retiree coverage merely changes or if you voluntarily drop it. Twenty-nine states give broader protection for changes to retiree coverage.
5. Your Medigap insurer fails you
Guaranteed issue rights also apply if your Medigap company goes bankrupt, your coverage ends through no fault of your own, or the company commits fraud.
What is not guaranteed under federal law
- Switching from one Medigap policy to another. Federal law gives current policyholders no guaranteed right to switch, although many states do (see birthday rules).
- Buying Medigap again after you voluntarily drop it, unless a trial right applies.
- Medigap for people under 65 with disabilities. Federal law has no guarantee for them; 38 states require insurers to offer at least one policy during an initial open enrollment period (KFF).
Plans C and F
Medigap Plans C and F are not available to people who became eligible for Medicare on or after January 1, 2020. Federal law bars new policies that cover the full Part B deductible.
Sources
- Medicare.gov: Guaranteed issue rights
- Medicare.gov: Choosing a Medigap Policy (PDF)
- Medicare.gov: How Medigap works
- KFF: Medigap Guaranteed Issue Requirements: An Overview of Federal and State Rules (Oct 13, 2026)
- Medicare.gov: Special Enrollment Periods
Common questions
How long do I have to apply after my Medicare Advantage plan ends?
Federal guidance says up to 63 days after your coverage ends. You can also apply up to 60 days before it ends if you are choosing to leave.
Is my guaranteed issue right the same in every state?
No. Federal rules set the minimum. States can add rights, such as year-round guaranteed issue in Connecticut, Massachusetts and New York, or longer trial periods in Maine.