GUARANTEED ISSUE RIGHTS SPOUSE DEATH

If I had medical coverage through my spouse’s employee retirement plan and my spouse dies, can I get new coverage – even if I have pre-existing health issues?

Can an insurance company charge me more for a Medigap (Medicare Supplement) Plan because I have pre-existing health issues? 

It’s very possible that you can get new medical coverage and not have to pay more because of pre-existing health issues.

IMMEDIATELY contact your Social Security office to make sure you’re enrolled in Medicare Part B. If you do not have Medicare Part B you must act NOW to turn on Medicare Part B. Contact your Social Security office without delay!

When your spouse died you lost credible health coverage and you MUST get enrolled in Medicare Part B immediately (within 3 months of losing credible coverage) if you are not already enrolled, or you could lose your guaranteed rights.

Since you had credible coverage while ensured under your spouse’s plan you MAY have certain guaranteed issue rights known as Medigap Protections. This means that insurance companies could be required to sell you certain Medigap plans. 

In addition, because you had credible coverage these Medigap plans would cover all of your pre-existing conditions and CANNOT charge you more for your coverage because of current, or previous, health conditions.

However, when you spouse died you lost your credible coverage. This means that your guaranteed issue rights may lapse so you must act without delay. 

It’s VERY important that you keep all of these records:

• Copies of all letters, notices, emails, and/or claim denials that have your name on them as proof of your coverage being terminated
• All postmarked envelopes that these papers come in to prove when they were mailed
• 
  

You may be required to provide these documents with your Medigap application to prove you have a guaranteed issue right.

If you had Medicare Part A and Medicare Part B while you were on your spouse’s coverage you should receive a letter from your spouse’s insurance company.

More information about your Medicare options is available from Medicare.gov at this link: 

https://www.medicare.gov/supplements-other-insurance/when-can-i-buy-medigap/guaranteed-issue-rights