What is a Medicare Supplement Guaranteed Issue Plan?

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Dear Toni:

I have decided to retire when I turn 65 in February and need to enroll in Medicare Parts A and B. My husband, Harry, is 74 and he enrolled in Medicare Parts A and B when he turned 65, remaining on my employer benefits with health issues.

His primary doctor’s office manager expressed concerns because of my husband’s intense lung problems, causing surgery in 2026. She suggested that Harry apply for a Medicare Supplement.

Toni, please explain how we enroll in our Medicare Supplement plan when I retire.

-- Carolyn 

Hello, Carolyn:

Medicare Supplement Insurance (Medigap) is a private insurance policy that covers costs not picked up by Original Medicare.

I have good news for you, Carolyn. Medicare has special rules for employees, or their spouses, who are covered by an employer’s group health insurance plan. Harry is lucky because there is a Medicare Supplement rule that allows him to avoid answering the underwriting questions since he enrolled in Medicare Part B, when he turned 65 over 9 years ago. Had Harry not been enrolled in your employer’s group health insurance plan, he would have had to answer underwriting question to qualify for his Medicare Supplement. Let me explain how he qualified.

Since he is leaving your employer health plan, Harry qualifies for the 63-day Guaranteed Issue Period to apply for a guaranteed issue Medicare Supplement without medical underwriting. He will need your company benefit plan termination letter to prove that he is in a Guaranteed Issue Period.

With a guaranteed issue plan, an insurance company:

--Must sell you a Medicare Supplement policy. “You have the right to buy Medicare Supplement plan A, B, C, D, F, or G that is sold in your state by any insurance company. Harry is not eligible for Plan G with Guaranteed Issue Plans since his Medicare Part A began prior to January 1, 2020.(Harry’s Part A began in 2017) Those whose Medicare Part A begins after January 1, 2020, are eligible for Plans D and  G not Plans C or F for a guaranteed issue plan.

--Must cover all your pre-existing health conditions.

--Cannot charge the insured more for a Medicare Supplement policy, regardless of past or present health problems. This is good news for Harry with his health issues.

Carolyn, since you are turning 65 in February, you’ll have a less stressful Medicare enrollment than Harry because you are in your Medicare Supplement Open Enrollment Period. On page 77 of the    2026 Medicare & You handbook, it states, “The best time to purchase a Medicare Supplement policy is during your Medigap Open Enrollment Period. This 6-month period begins on the first day of the month you have Medicare Part B (Medical Insurance), and you’re 65 or older.”

Enrolling in Medicare Part B, the correct way, when you or your spouse is working full-time with employer benefits, is extremely important. Not only do you want to avoid a Medicare Part B penalty; you also want to be able to enroll in a Medicare Supplement while avoiding medical underwriting to be accepted.

Chapter 3 of Toni’s Medicare Survival Guide Advanced Edition explains in depth what is a Medicare Supplement and the rules of enrolling in a Medicare Supplement policy the proper way. Many Americans do not realize that enrolling in Medicare Part B is as valuable as gold and should be treated carefully. Take your time and explore your Medicare plan options. Remember to discuss your Medicare needs with your medical providers when exploring your Medicare plan options.

For a Medicare checkup, email [email protected] or call 832/519-8664. Toni’s new course, Confused about Medicare, a downloadable video series, and the “Medicare Survival Guide Advanced” edition are available at www.tonisays.com. Sign up for the Toni Says newsletter on the Toni Says website at tonisays.com to keep up to date with Medicare changes.