Guaranteed Issue Rights for Medi-Gap when you enroll beyond age 65 for Part B
as you had Qualifying Employer Coverage

 

Situation  1

from Blue Shield CA Guaranteed Acceptance Guide

Situation 1 - New to Part B
Situation 1 – New to Part B
Situation 4
You received notice of termination, or your coverage was terminated from any 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.

3 comments on “Loss of Employer Coverage – New to Part B

    • Good POINT!

      Excerpt from Medicare Medi Gap Guide # 02110 * Medicare.Gov *

      It’s also important to understand that your Medigap rights may depend on when you choose to enroll in Medicare Part B. If you’re 65 or older, your Medigap Open Enrollment Period begins when you enroll in Part B and it can’t be changed or repeated.

      In most cases, it makes sense to enroll in Part B and purchase a Medigap policy when you’re first eligible for Medicare, because you might otherwise have to pay a Part B late enrollment penalty and you might miss your Medigap Open Enrollment Period. However, there are exceptions if you have employer coverage.

      From prior conversations and emails, you’ve stated that you have an application pending for Part B, but have not been enrolled. I’d check and see if you can get the application cancelled, as if you never asked to be enrolled in Part B.

      Either you or I can write to HICAP – CA Advocates and see what light they can put on the subject.

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