What to Ask About Medigap

When you are speaking to insurance representatives about Medigap policies, here are some questions to keep in mind:

• Am I enrolling while I am in my open enrollment period? If not, do I have a guaranteed issue right?
• What is the Medigap policy’s monthly premium?
• Is this premium based on my:
  • Health status
  • Gender
  • Smoking
  • Marital status
    Or anything else?
• Are the premiums:
  • No-age-rated (community-rated), meaning everyone in my area pays the same premium regardless of their age?
  • Issue-age-rated, meaning the premium is based on how old I was when I bought the policy?
  • Attained-age-rated, meaning the premium increases based on my age?
• Will the company refuse to sell me a Medigap based on my health status?
• Does the policy impose a pre-existing condition waiting period?
  • How long is the waiting period before my coverage begins?
  • Do I have prior creditable coverage to reduce my waiting period?

Other considerations

• If you do not have the right to buy a Medigap, ask the insurance representative how much extra you will be charged for purchasing one.
• If you are under 65, make sure the company you are considering sells to individuals under 65.
• Remember to keep track of who you spoke with, when you spoke with them, and the outcome of the call.

© Medicare Rights Center. Used with permission.

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