Roadmap to Medicare-Guaranteed Issue – HTA Insurance Services

Roadmap to Medicare

Already Enrolled in Medicare, Coming off Group Insurance

More information on:

Your Roadmap is based on…

You are over age 65
You already have Medicare Part A and Part B
You have had Medicare Part B for longer than 6 months
You are currently covered by a group health plan, retiree plan, COBRA, or severance plan
Your current coverage is ending or will no longer be available to you
You are within 60 days of your current coverage ending

Secondary Insurance Options

You have the option to purchase secondary coverage to supplement your Medicare A and B. You will have the option to choose a Medicare Advantage Plan or Medicare Supplement Insurance and a Medicare Prescription Drug Plan.

Contact HTA to schedule a Roadmap to Medicare Appointment to discuss your secondary insurance options if you have not already done so.

Important Enrollment Timing

Because you are losing your current coverage, you may have a limited window to enroll in secondary Medicare coverage.

This is often called a Guaranteed Issue Period or Special Election Period.

During this time, you may be able to enroll in certain plans without answering medical questions.

This window generally lasts 2 months after your current coverage ends.

If you do not enroll during this period, you may have fewer options later. For Medicare Supplement Insurance, you may also need to answer medical questions and be approved by the insurance company.

Medicare Supplement Guaranteed Issue Options

Not all Medicare Supplement plans are available on a Guaranteed Issue basis.

The plans available to you may depend on:

When you turned 65
Your state of residence
The insurance carrier
The type of coverage you are losing
Whether you’re voluntarily or involuntarily losing coverage

If you turned 65 before January 1, 2020

Plans F and C are typically available on a Guaranteed Issue basis.

If you turned 65 on or after January 1, 2020

Plans G and D are typically available on a Guaranteed Issue basis.

Other plan options are available but may require medical underwriting, depending on the insurance carrier and your state of residence.

Additional Information
Underwriting Considerations

Medicare Supplement Insurance has an Open Enrollment Period for the first 6 months that you are enrolled in Medicare Part B. During this time, you will be able to purchase ANY medicare supplement plan with no medical underwriting.

Unless you have a Guaranteed Issue circumstance, Medicare Supplement plans are medically underwritten after the first 6 months on Medicare Part B.

Medicare Advantage Plans and Medicare Prescription Drug Plans provide an Initial Election Period when you enroll in Medicare, a Special Election Period when you come off your group plan, and also allow you to change plans once a year during the Annual Election Period (October 15^th through December 7^th) without medical underwriting.

Additional Considerations

Spouse Under Age 65- If your spouse relies on your group health plan for benefits, please be mindful that if you come off your group plan, your spouse will have to go on COBRA, seek benefits through their respective employer, or purchase individual health insurance until they become Medicare eligible.

Effective Date Considerations- Reminder, when you apply for Medicare at age 65, you cannot choose a specific effective date for the benefits (and premiums) to start. The only way to influence the effective date is by which month you enroll online. Please contact us ASAP if you are trying to achieve a specific start date that is something other than the first of the month of your 65th birthday (possibly to coordinate with your group plan ending).

Important HSA Considerations– You cannot continue to contribute to your Health Savings Account (HSA) once you enroll in Medicare Part A. If you are enrolling in Medicare after age 65, your Part A effective date may be back dated up to 6 months. Please contact us to discuss the HSA maximum contribution rate for you circumstances. Click Here for Details and Rules.

This does not apply to Flexible Spending Accounts (FSA) or Health Reimbursement Accounts (HRA). Medicare does not have any restrictions on these types of accounts.