G is for Guaranteed Issue - What's guaranteed about it?

May 16, 2017

The Health Care debate continues to rage, even with everything else that is going on in our nation.  We are continuing our series on health care terms so that you can better understand the issues.  Today we are discussing Guaranteed Issue.

 

Simply put, guaranteed issue means that an insurance company is required to enroll you on a plan regardless of any factors that may influence how much you will utilize your benefits.  Age, gender, pre-existing conditions and other criteria may not be considered. 

 

Guaranteed Issue is separate from how much premium you will be charged.  You may be charged more than someone else, but you will be allowed to enroll in a plan.

 

Please keep in mind that while current health plan laws mean that companies cannot exclude for pre-existing conditions, you may not always be eligible for a guaranteed issue policy.  You must purchase health insurance during Open Enrollment periods or experience a life event that qualifies you for a Special Enrollment period. 

 

For example, when you turn 65, you become eligible for Medicare and your initial enrollment in a MedAdvantage or MedSupplement plan will be classified as Guaranteed Issue.  The insurance companies must enroll you.  However, if you don’t apply during your initial eligibility period, or you choose to switch plans at a later date, you may have to go through underwriting and your application may be denied.

 

Don’t get stuck in a situation where you can’t buy coverage or you have to go through unwanted underwriting.  Make sure that you apply for coverage during Open Enrollment periods, and if you lose your coverage, make sure you replace it in a timely manner.

 

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