Situation  1 from Blue Shield Guaranteed Acceptance Guide

Situation 1 - New to Part B
Situation 1 – New to Part B

 end-stage renal disease

 

You received notice of termination, or your coverage was terminated fromany employer-sponsored health plan, including an employer-sponsored
retiree health plan. This includes termination for loss of eligibility due to divorce or death of a spouse.
Your plan choices
Plan A, C, D, F, High Deductible F, K, or N
When to apply Blue Shield must receive your application within six (6) months of the notice of termination, or if no notice is received, within six (6) months
of the date your employer-sponsored health coverage ended.
You must supply this documentation
Be sure to complete the Current Insurance Coverage information section (including the end date) of your signed Medicare Supplement plan application
Situation  11
You enrolled in an employer-sponsored health plan that supplements
Medicare, and either of the following apply:
• The plan either terminates or ceases to provide all of those
supplemental health benefits to you;
or
• The employer no longer provides you with insurance that covers all
of the payment for the 20% coinsurance.
Your plan choices
Plan A, C, D, F, High Deductible F, K, or N
When to apply
You may submit an application to Blue Shield during the guaranteed
acceptance period, which starts from the later of the following two dates,
and ends sixty-three (63) days after the date coverage is terminated:
• The date you received a notice of termination, or if no notice is received,
on the date you received notice denying the claim because of
termination of benefits;
or
• The date coverage is terminated.
You must supply this documentation
Be sure to complete the Current Insurance Coverage information section
(including the end date and reason for coverage ending) of your signed
Medicare Supplement plan application.

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