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Medicare Supplement State Exceptions

Special Guaranteed Issue Rules By State 

CA: Birthday Rule
  • For 60 days after Birthday policyholder may change from current Medicare Supplement Plan to a Medicare Supplement plan of equal or lesser benefits with any carrier. 
  • Chosen plan will begin the first of the ensuing month  
  • Request to change cannot be made until policyholder’s exact birthday. 
  • Carrier must require proof of current Medicare Supplement coverage. Reference desired carrier for which document(s) are required. 
CT: Year Round
  • Guaranteed Issue to all Medicare Supplement Plan letters and carriers regardless of current coverage. 
  • If changing from Medicare Advantage (MAPD), must wait until Annual Enrollment Period unless you have a valid Special Enrollment Period to leave leave your MAPD. 
 MA: Annual
  • Guaranteed Issue from 02/01 to 03/31 each year for those who missed Open Enrollment Period or to change Medicare Supplement (MS) Plan type or carrier. One cannot use this to change from Medicare Advantage (MAPD) to MS.  
  • Carrier can elect to begin new policy as late as 06/01.  Please reference desired carrier for their policy regarding effective dates. 
ME: Several Options 
  • All carriers must offer Guaranteed Issue (GI) to Medicare Supplement (MS) Plan A for everyone regardless of current coverage either year round or annually for 30 day period (this period can differ from carrier to carrier).
  • As long as one has not had more than 90 day gap in MS coverage, they will have GI to change to a different MS Plan of equal or lesser benefits with any carrier. 
  • Also offers GI within 90 days of losing ACA plan. 
MO:  Anniversary Rule
  • For 30 days before or after current Medicare Supplement (MS) policy anniversary can change to the same MS Plan letter with another carrier 
  • Chosen plan will begin the first of the ensuing month. 
  • Policy holder cannot chose a different MS Plan letter. 
  • Carrier may require proof of current coverage. Reference desired carrier for which document(s) are required. 
NY: Year Round
  • Guaranteed Issue to all Medicare Supplement Plan letters and carriers regardless of current coverage. 
  • If changing from Medicare Advantage (MAPD), must wait until Annual Enrollment Period unless you have a valid Special Enrollment Period to leave leave your MAPD. 
OR: Birthday Rule
  • For 30 days before and after EXACT birthday, policyholder may change from current Medicare Supplement Plan to a Medicare Supplement plan of equal or lesser benefits with any carrier. 
  • Chosen plan will begin the first of the ensuing month  
  • Carrier may require proof of current Medicare Supplement (MS) coverage. Reference desired carrier for which document(s) are required.
WA: Year Round
  • Guaranteed Issue is available as long as you have not had a lapse in other MS coverage longer than 90 days. 
  • Policyholders with Plan A can only change to another Plan A 
  • All other policyholders can change to any other Medicare Supplement (MS) Plan letter.  

Both MN and WI have considered passing GI laws for MS policy holders but legislation has failed.  

Visit the following pages for more information on plan options

 

Medicare Supplement Plan Options

Medicare Advantage Plan Options