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En español | The best time to buy Medigap insurance is during a period when you have guaranteed protections — under either federal law or the laws of your state — to purchase a policy without the insurance company being able to refuse coverage or charge you higher premiums based on your past or current medical conditions. These protections may vary according to your age and where you live.
Federal law prohibits insurance companies from refusing to sell you a Medigap policy, or from charging you higher premiums based on your current health status or preexisting medical conditions, provided that you buy it within certain specified time frames:
Outside of these periods, you may still be able to buy a Medigap policy, but in most areas insurance companies would take your current and past medical conditions into account when determining the premium — a practice known as medical underwriting — making it much more expensive.
However, your state may provide greater protections under its own law. For example, a few states allow you to buy a Medigap policy, or switch to another, with no medical underwriting at any time or to do so every year during your birthday month. To find out requirements and protections in your own state, contact its department of insurance.
Even within periods of guaranteed issue, insurance companies may exclude coverage for preexisting medical conditions for up to six months after the policy takes effect. However, they cannot make you wait in this way if you’ve had continuous “creditable coverage” for at least six months before buying the Medigap policy. “Creditable coverage” includes health insurance from a current or former employer, a government program such as Medicaid or the Department of Veterans Affairs (VA) health system, or private insurance you have bought yourself.
For more information, see the official publication “Choosing a Medigap Policy (PDF)”.
Federal law does not give you the same protections that are given to people 65 and older when buying Medigap. Therefore, whether you can buy any Medigap policy — or one that is affordable — depends on your own state’s law.
In many states, insurance companies are not required to sell any Medigap policies to you. Some states require one or two policies to be made available. Most states allow insurers to take your health status and preexisting medical conditions into account when determining your premium, which can greatly push up the cost.
But a few state laws do provide more help — insisting, for example, that people with Medicare due to disability receive the same protections that federal law provides for people 65 and older. To check out the law where you live, contact your state's department of insurance.
If you are unable to buy a Medigap policy right now, or can only buy one that charges you very high premiums, remember that when you turn 65, the clock will be reset. You will be eligible for Medicare based on age instead of disability, and you will be able to choose any Medigap policy of your choice with full federal protections — provided that you buy one within six months of your 65th birthday, unless you happen to live in one of the few states that allow you to buy Medigap at any time.
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