Medigap Guaranteed-Issue Rights: Rules & Eligibility
A Medigap guaranteed-issue right lets you buy certain Medicare Supplement plans without health questions, but only after specific events, such as your Medicare Advantage plan leaving your area or your employer coverage ending.
It isn't a general right to switch whenever you want.
Since our agency began helping Medicare beneficiaries in 2011, this is the rule I see misunderstood most often, usually by someone who assumed they could "just go back to a supplement" and found out otherwise.
You have a federal guaranteed-issue right when you lose or leave certain coverage through no choice of your own, or during a one-year Medicare Advantage "trial."
In most of these situations, insurers must sell you Medigap Plan A, B, C, D, F, G, K or L. Plans C and F are only for people eligible for Medicare before 2020. Plan N is not on the federal list.
You usually have 63 days after your old coverage ends to apply, and in several situations you can apply up to 60 days before.
What Are Medigap Guaranteed-Issue Rights?
Outside of a few protected windows, Medigap insurers in most states can review your health history before accepting you.
That's called medical underwriting, and it can mean a higher premium or a denied application.
A guaranteed-issue right switches underwriting off for a limited time. According to Medicare's official Medigap guide, when you have one, the insurer:
- Must sell you a Medigap policy from the plans covered by your right
- Must cover your pre-existing conditions, with no waiting period
- Can't charge you more because of past or present health problems
Premiums can still differ by age, ZIP code and tobacco use, and from one insurer to the next. Guaranteed issue protects you from health-based pricing, not from shopping around.
When Do You Qualify for Guaranteed Issue?
Federal law spells out a short list of qualifying events. If your situation isn't on this list, you don't have a federal right, though your state may add its own.
| Your situation | Plans you're guaranteed | When to apply |
|---|---|---|
| Your Medicare Advantage plan leaves Medicare, stops serving your area, or you move out of its service area | Standard GI plans* | As early as 60 days before coverage ends, up to 63 days after |
| You have Original Medicare plus employer group coverage (including retiree, union or COBRA coverage) that pays after Medicare, and that coverage is ending or stops paying its share Whether you qualify depends on the type of coverage and how it ends. |
Standard GI plans* | Up to 63 days after the latest of: coverage ending, the notice date, or a claim denial (if that's how you learned it ended) |
| You have a Medicare SELECT policy and move out of its service area | Standard GI plans* sold in your current or new state | As early as 60 days before coverage ends, up to 63 days after |
| Trial right: You joined a Medicare Advantage plan or PACE when you were first eligible for Medicare Part A at 65, and within the first year of joining, you want to switch to Original Medicare | Any Medigap plan sold in your state | As early as 60 days before coverage ends, up to 63 days after |
| Trial right: You dropped a Medigap policy to join Medicare Advantage (or SELECT) for the first time, and leave within the first year | Your old Medigap policy if the same insurer still sells it; otherwise standard GI plans* | As early as 60 days before coverage ends, up to 63 days after |
| Your Medigap insurer goes bankrupt, or your policy ends through no fault of your own | Standard GI plans* | Up to 63 days after coverage ends |
| You leave a Medicare Advantage plan or drop Medigap because the company broke the rules or misled you | Standard GI plans* | Up to 63 days after coverage ends |
*Standard GI plans are Medigap Plans A, B, C, D, F, G, K or L sold in your state. Plans C and F aren't available to people who became newly eligible for Medicare on or after January 1, 2020. Source: Medicare.gov, Choosing a Medigap Policy.
Most of these events share one thing in common: the coverage change happened to you.
The two trial rights are the exception, and they're time-limited. After your first 12 months in Medicare Advantage, that safety net is gone.
Turning 65 isn't on this list on purpose. That's your Medigap Open Enrollment Period, a separate protection compared further down this page.
Which Medigap Plans Can You Buy?
This is where the old version of this rule gets oversimplified. A guaranteed-issue right usually does not let you buy any Medigap plan.
Here's the list that applies in most federal guaranteed-issue situations, per Medicare.gov:
*Plans C and F aren't available to people who became newly eligible for Medicare on or after January 1, 2020.
The first trial right generally gives you the broadest choice, covering any Medigap plan sold in your state.
But you have to meet its exact conditions. Per Medicare's guide, you must have joined a Medicare Advantage plan or PACE when you were first eligible for Medicare Part A at 65.
You must also switch back to Original Medicare within the first year after joining that plan. Simply being in a plan for less than a year isn't enough.
Some insurers will still let you apply for Plan N during a guaranteed-issue window, but they're allowed to underwrite that application.
Plan N isn't included in the standard federal guaranteed-issue list.
If you qualify for guaranteed issue and want to avoid medical underwriting, Plan G may be an option worth comparing.
It's also worth reviewing the premiums and benefits of the other plans your right covers. Your state's laws may give you additional choices.
If you're not sure which protected plan fits, our Medigap comparison chart shows the benefits side by side.
How Long Do You Have to Apply?
The general rule is 63 days after your old coverage ends. But the window often opens earlier, and starting early is usually smarter.
Here's how it works for one of the most common 2027 situations: a Medicare Advantage plan that isn't renewing and ends December 31, 2026.
Window opens
You can apply up to 60 days before your Medicare Advantage coverage ends.
Target start date
You can arrange for Medigap to begin January 1, 2027, when Original Medicare becomes your primary coverage.
Window closes
63 days after coverage ends. After this, normal underwriting applies.
Waiting until February is technically allowed. But unless you have other supplemental coverage in the meantime, you'd be responsible for Original Medicare's deductibles and 20% coinsurance until your Medigap policy starts.
You'll also need a stand-alone Part D drug plan. A plan nonrenewal generally comes with a Special Enrollment Period to choose one.
Apply for the Medigap policy in November or early December, and pick your Part D plan at the same time.
Most of the stress I see in January comes from people who did one and forgot the other.
How to Prove Your Guaranteed-Issue Right
Insurance companies generally require documentation showing that you qualify for guaranteed issue.
The type of proof depends on the event, so keep copies of your coverage notices and termination letters.
- Find your proof. Common documents include a Medicare Advantage nonrenewal notice, an employer or COBRA termination letter, a Medigap cancellation notice, or a claim denial showing coverage ended.
- Confirm your dates. Note the exact day coverage ends. Your window is counted from that date, not from when you happened to read the letter.
- Pick a protected plan. Choose from the plans your situation covers, then compare prices. The same plan letter can vary widely by insurer, and our guide to researching Medigap companies walks through what to check beyond price.
- Apply and flag the right. Tell the insurer, or your agent, that you're applying under a guaranteed-issue right, and attach your proof.
- Line up your other pieces. Enroll in a Part D plan, and make sure you're back on Original Medicare before the Medigap start date.
Don't throw away your Medicare Advantage nonrenewal letter, even if you plan to stay with the same insurer for a different plan.
That letter is the cleanest proof of your right. Requesting a replacement in December, when carriers are swamped, can stall an application that should have taken days.
Leaving Medicare Advantage on Purpose Doesn't Count
Deciding to leave a Medicare Advantage plan during the Annual Enrollment Period does not, by itself, create a federal guaranteed-issue right.
If your plan is still being offered and you simply want out, insurers in most states can underwrite your Medigap application.
The exceptions are the one-year trial rights, a plan that is actually leaving your area, or a state law that gives extra protection.
This matters more than usual right now.
Plan exits from carriers like UnitedHealthcare and Humana mean many people do have a real guaranteed-issue right this fall.
But I also hear from people whose plan is continuing and who assume the same rules apply to them because a neighbor's plan was dropped. Check whether your plan is ending before you cancel anything.
If you are healthy and simply prefer Original Medicare, switching may still be possible with underwriting. Our guide on switching from Medicare Advantage to Medigap covers that path.
Do States Offer Additional Protections?
Yes, and they're expanding. According to KFF's October 2026 review of Medigap guaranteed-issue rules, several states now go well beyond the federal minimum.
- Year-round access: Connecticut and New York require insurers to sell Medigap year-round. Massachusetts, which uses its own plan types, also gives broad ongoing access.
- Maine: insurers must offer Plan A without underwriting for at least one month each year, and enrollees can generally move to a plan with equal or lesser benefits, per the Maine Bureau of Insurance.
- New annual windows: Minnesota began an annual window for people ages 65 to 70 on August 1, 2026, and Rhode Island added annual protections for people leaving Medicare Advantage.
- Birthday and anniversary rules: a growing number of states let existing Medigap enrollees switch to a plan with equal or lesser benefits around their birthday or policy anniversary.
These rules change often, and the details matter, including which plans qualify and how long the window lasts. Before relying on a state protection, confirm it with your state insurance department or a licensed agent.
Guaranteed Issue vs. Medigap Open Enrollment
These two protections get mixed up constantly. They both skip underwriting, but they work very differently.
| Medigap Open Enrollment | Guaranteed-Issue Right | |
|---|---|---|
| When it happens | Once, for six months starting when you're 65+ and enrolled in Part B | After a specific qualifying event |
| Plans available | Any Medigap plan sold in your state | Usually a limited list (no Plan N) |
| Pre-existing condition waiting period | Possible, up to six months, if you lacked prior creditable coverage | Not allowed |
| Can it happen more than once? | No | Yes, each time a qualifying event occurs |
If you're in your Open Enrollment Period, use it. You get the full menu of plans, and you won't have to prove anything.
Guaranteed issue is the safety net for later, when coverage changes on you. Our Open Enrollment guide covers the timing rules in detail.
Not sure if you qualify? Call 888-414-4547 and we'll check your situation.
Common Questions About Guaranteed Issue
If my Medicare Advantage plan is ending and I pick another Advantage plan, do I lose my right?
Your guaranteed-issue window still runs on its normal timeline, but using it requires being on Original Medicare.
If you enroll in a new Advantage plan and later change your mind, leaving it may require a separate election period, and your window may close in the meantime.
If you're torn between the two, decide before your plan ends.
Do guaranteed-issue rights apply if I'm under 65?
Federal rules are built mainly around beneficiaries 65 and older, and many states don't require insurers to sell Medigap to people under 65 on Medicare due to disability.
Some states do. Check your state's rules, and note that you'll get a full Medigap Open Enrollment Period when you turn 65.
Can an insurer charge me more under guaranteed issue?
Not because of your health. You pay the same rate as anyone else your age, in your area, with the same tobacco status.
That rate can still vary a lot between insurers, and it can rise over time. Our guide to Medigap rate increases explains why.
Bottom Line
Guaranteed-issue rights are valuable, but they're narrow.
If your Medicare Advantage plan is ending, your employer coverage is ending, or you're within your first year of a trial, you likely have a protected window. Use it early, keep your paperwork, and choose from the plans your situation covers.
If you're simply unhappy with your current plan, don't assume you're protected. Check your state's rules first, and expect underwriting in most states.
And if you're new to Medicare, remember that your Open Enrollment Period is the broadest protection you'll ever get. It's the right time to settle the Medigap vs. Medicare Advantage question carefully.
