Can I Be Turned Down for Medicare Supplement Insurance?
This article was updated on: 09/01/2017
Medicare Supplement plans are sold by private insurance companies to work alongside your Original Medicare (Part A and Part B) coverage and help cover out-of-pocket costs such as copayments, coinsurance and deductibles. These plans could help you save on Medicare health-care costs, especially if you receive extensive medical care.
Medicare Supplement plans are standardized with letter-designated names in 47 states (Massachusetts, Minnesota, and Wisconsin have their own standardized plans). If you’re enrolled in Medicare, you can only be denied a Medicare Supplement plan under certain conditions. The list of conditions below is not comprehensive, but it can help you understand the limited circumstances in which you might be denied a Medicare Supplement plan.
Turned down for Medicare Supplement condition 1: You aren’t enrolled in Medicare Part A and Part B.
You must have Medicare Part A and Part B to enroll in a Medicare Supplement plan. If you have neither Part A nor Part B, or just Part A or just Part B, you’re not eligible for Medicare Supplement insurance. Medicare Supplement plans are intended only for Medicare beneficiaries with both Part A and Part B.
Turned down for Medicare Supplement condition 2: You’re enrolled in a Medicare Medical Savings Account (MSA) plan or any Medicare Advantage plan.
It’s illegal for anyone to sell you a Medicare Supplement policy if you have a Medicare Medical Savings Account (MSA) plan, or any kind of Medicare Advantage plan, unless you’re switching back to Original Medicare. Medicare Supplement plans don’t work with Medicare Advantage plans. If you have a Medicare Advantage plan, you can still apply for Medicare Supplement, but you must drop the Medicare Advantage plan before the Medicare Supplement plan begins.
Turned down for Medicare Supplement condition 3: You have Medicare Part A and Part B but you’re under age 65
Some people qualify for Medicare coverage under age 65 because they have a disability or a certain disease such as end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS). However, federal law doesn’t require private insurance companies to sell Medicare Supplement policies to people under 65. Some states do require the private insurance companies within that state to sell Medicare Supplement policies to people under 65. If you live in a state such as California or Vermont that does sell Medicare Supplement to people under 65 under certain circumstances, you may be denied Medicare Supplement insurance if you have ESRD.
Turned down for Medicare Supplement condition 4: You’re not in your Medicare Supplement open enrollment period
You could be denied a Medicare Supplement policy if you apply for it outside of your Medicare Supplement Open Enrollment Period. This open enrollment period lasts for six months and begins in the month that you’re both at least 65 years old and enrolled in Medicare Part B. During this period, an insurance company cannot consider your health status when evaluating your application (however, a waiting period related to your health condition may apply). You can buy any Medicare Supplement plan that is sold in your state regardless of health problems. After this period ends, insurance companies can consider your health condition when deciding to accept or reject your application. They could deny you coverage or charge you a higher premium if they think you will be too expensive to cover based on your health history.
If you still have questions about being denied a Medicare Supplement plan, I am happy to help you find answers. If you prefer, you can schedule a phone call or request an email by clicking on the buttons below. You can also find out about plan options in your area by clicking the Compare Plans button. If you’d like to talk to someone today about Medicare, give me or one of our licensed insurance agents a call at 1-844-847-2660 (TTY users can call 711) Monday through Friday, 8AM to 8PM ET.
The product and service descriptions, if any, provided on these Medicare.com Web pages are not intended to constitute offers to sell or solicitations in connection with any product or service. All products are not available in all areas and are subject to applicable laws, rules, and regulations.
Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the Federal Medicare program.
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