Situation #4

You joined a Medicare + Choice plan or PACE program but now have decided to leave it.

In order to have a guaranteed issue right to purchase a Medigap policy in this situation, you must:

• Have joined the Medicare + Choice or PACE program when you were first eligible at age 65; AND
• Leave the plan within 1 year of joining

Note: If the 1-year period after you join the plan (the guaranteed issue period, also called the Medicare + Choice Trial Period) is interrupted for any reason, the 1-year period begins again. This gives you another year to try another plan. The total guaranteed issue period cannot exceed 2 years.

Plan Options

You have the right to apply for any Medigap policy sold in your state.

Time Limit

You must notify your current plan that you are leaving so you have proof of disenrollment. You must apply for a Medigap policy during the period that begins 60 days before your coverage is discontinued and ends 63 days after your coverage is discontinued.

If you are still in your Medigap Open Enrollment Period, you can buy any Medigap policy until your Open Enrollment Period ends. (This may be longer than the 63-day period after your coverage is discontinued.)

Select the Beneficiary Profile icon for an example of a beneficiary in this situation.

Select the Chart icon for an overview of guaranteed issue rights.

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Last Updated 11/02/2004