Medicare supplement insurance — consumer protection

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Medicare provides important health insurance benefits, but it leaves some gaps in coverage. Many people turn to Medicare supplement insurance to fill those gaps. “It’s important to know your rights and protections when it comes to supplemental insurance,” said Kris Gross from the state of Iowa’s Senior Health Insurance Information Program. The first protection you’ll encounter is the “open enrollment period.” The open enrollment guarantees you the right to buy any Medicare supplement insurance policy sold in Iowa. A company cannot reject you for any policy it sells, and it cannot charge you more than anyone else your age. The open enrollment starts when you are age 65 or older and enroll in Medicare Part B for the first time. It ends six months later. The open enrollment does not apply to people who go on Medicare before age 65 because of disability or end-state renal disease. Medicare supplements can have a waiting period before paying benefits for pre-existing conditions, but it is limited to six months. You can avoid a waiting period during the open enrollment period if you apply for the supplement within 63 days of the end of previous health coverage. You can also avoid a waiting period for pre-existing conditions if you decide to change policies. If you apply for a new policy to replace one you have had for at least six months, and no gap occurs between the end of the old Medicare supplement and the beginning of the new supplement, the waiting period is waived. This only applies when replacing a Medicare supplement with another Medicare supplement. Individuals covered by an employer group health plan, which pays benefits after Medicare pays, are guaranteed the right to buy certain Medicare supplements, if their employer plans stop providing some or all health benefits. Any waiting period for pre-existing conditions may also be waived in this situation. Another important protection applies when a person becomes eligible for Medicaid. Most Medicare supplements can be suspended for up to 24 months when you become eligible for Medicaid. You have to request the suspension within 90 days of Medicare eligibility. For more information, or questions on these protections and others related to Medicare supplement insurance, contact SHIIP at 1-800-351-4664 (TTY 1-800-735-2942). You can also request SHIIP materials, which includes information about these protections. Ask for the Iowa Guide to medicare supplement insurance or special events that guarantee your right to buy medicare Supplement Insurance. These can also be found on the SHIIP Web site www.TheRightCallIowa.gov . SHIIP is a service of the state of Iowa and does not sell or promote any insurance policy, company or agent. All services are free, confidential and objective. SHIIP has counselors across the state who are available to meet with you one-on-one to discuss Medicare supplement insurance and other Medicare issues. Call 1-800-351-4664 for the site nearest you.