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Guaranteed Issue Medicare Supplement: Your Rights Explained

Reviewed by Russell Noga, Licensed Medicare Insurance Broker (all 50 states) — Last updated October 26, 2026

A guaranteed issue Medicare Supplement is a Medigap policy an insurer must sell you without health questions, because federal or state law gives you that right in a specific situation. Most rights last only a short time, so knowing your deadline is critical.

Outside your first Medigap open enrollment at 65, most insurers can ask about your health before they sell you a policy. If you have heart disease, diabetes or another condition, that can mean a higher price or a flat no. Guaranteed issue rights are the exceptions. They protect you when your coverage changes for reasons that are often out of your control.

This guide walks through the federal situations, the plans you can buy, the extra protections some states add, and the steps to use a right before it expires. For background on how insurers screen applicants, see what medical underwriting means for Medigap.

✔ Licensed in all 50 states
✔ Based on CMS 2027 data
✔ Free plan comparison

Key Highlights

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Guaranteed issue means no health questions, no denial and no higher price for health.

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Most federal rights require you to apply within 63 days after coverage ends.

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Your plan choices are usually limited to certain letters, such as Plan G.

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Some states add year-round rights or yearly birthday-rule switching.

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What Guaranteed Issue Rights Do

When you have a guaranteed issue right, an insurer that sells the covered plans in your state must accept your application. It cannot turn you down, cannot charge you more because of past or present health problems, and must cover pre-existing conditions without a waiting period.

With guaranteed issue

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No health questions

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No denial for medical reasons

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Standard rates for your age and area

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Pre-existing conditions covered right away

Without guaranteed issue

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Insurer may ask about health history

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Can deny or charge more

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May impose a waiting period

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Choices depend on approval

Guaranteed issue is different from your one-time Medigap open enrollment period. That six-month window starts when you are 65 and have Part B, and it lets you buy any plan. Guaranteed issue rights come up later, when specific life events happen. Learn more about the Medigap open enrollment period.

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Federal Guaranteed Issue Situations

Federal law lists a set of situations that trigger a right to buy Medigap. The table below summarizes the most common ones in plain language.

Situation When it applies
Medicare Advantage plan leaves Your plan stops serving your area or leaves Medicare
You move out of your plan’s area You had Medicare Advantage and move outside its service area
Employer or union coverage ends Group coverage that pays after Medicare ends or is cut back
Medigap company fails Your insurer goes bankrupt or your policy ends through no fault of yours
Insurer broke the rules Your Medigap or Advantage company misled you or broke Medicare rules
Trial right after first joining Advantage You dropped Medigap to try Medicare Advantage for the first time and leave within 12 months
Trial right at 65 You joined Medicare Advantage when first eligible at 65 and leave within 12 months

Based on federal Medigap guaranteed issue rules described by Medicare and CMS. Details and proof requirements vary by case.

Good to know: Leaving a PACE program can also trigger a right in some cases. Ask your State Health Insurance Assistance Program if you are unsure whether your situation counts.

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Which Plans You Can Buy

A guaranteed issue right does not always open every plan letter. In most federal situations, you can choose from a limited menu sold by any insurer in your state.

A, B, D, G

core plans usually available

K, L

cost-sharing plans also included

C, F

only if eligible for Medicare before 2020

If you became eligible for Medicare on or after January 1, 2020, Plans D and G take the place of Plans C and F. The trial right at 65 is broader and generally lets you buy any plan the insurer sells. When you used a first-time Advantage trial, you can usually go back to the same policy you dropped if the company still sells it.

Most people pick Plan G because it covers everything except the Part B deductible, which is $283 in 2026. Compare the details in our Plan G coverage details guide.

The 63-Day Deadline and Timing Rules

Timing is where many people lose their rights. In most federal situations, you can apply as early as 60 days before your other coverage ends, and no later than 63 days after it ends. Applying early helps you avoid a gap.

1

Watch for notices Save any letter saying your plan is ending, leaving your area or being cut.

2

Count the days Your 63-day clock usually runs from the date your coverage ends or the date on your notice.

3

Apply in writing Submit the Medigap application before the clock runs out and keep a copy.

4

Attach proof Include the termination letter or claim denial that shows why you qualify.

Do not wait: Once the window closes, the insurer can return to medical underwriting and may decline you.

State Extras: Year-Round Rights and Birthday Rules

Many states go beyond federal law. According to KFF’s October 2026 review, Connecticut and New York require insurers to sell Medigap year-round with no health questions. Massachusetts and Maine have annual windows, and several other states have expanded rights in narrower cases.

Sixteen states have a birthday rule or similar annual switching rule: California, Delaware, Idaho, Illinois, Indiana, Kentucky, Louisiana, Maryland, Nevada, New Mexico, Oklahoma, Oregon, Utah, Virginia, West Virginia and Wyoming. These let people who already have Medigap switch to another policy each year, usually around their birthday, without health questions.

How state extras usually work

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Birthday rules help current policyholders, not people without Medigap

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Most limit you to the same or lesser coverage

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Windows often last 30 to 63 days

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Missouri uses a window around your policy anniversary

Rules change, so check with your state insurance department before you count on one. Our page on switching Medigap companies covers how a change works in practice.

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Guaranteed Issue After Leaving Medicare Advantage

A common question is whether you can drop a Medicare Advantage plan during the Annual Enrollment Period, October 15 to December 7, 2026, and buy Medigap. You can switch back to Original Medicare, but in most states the Medigap company can still ask health questions unless you have a trial right or another guaranteed issue situation.

You likely have a right

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You joined Advantage at 65 less than a year ago

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You left Medigap for Advantage for the first time within 12 months

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Your plan is leaving your area

You likely do not

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You have been in Advantage for years and simply want to change

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You moved within your plan’s service area

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You missed the 63-day window

If you do not have a right, you can still apply and may be approved if you are in good health. See changing from Medicare Advantage to Medigap for the full picture.

How to Use Your Right Step by Step

1

Confirm the trigger Match your situation to a federal right or a state rule.

2

Gather paperwork Keep the notice, letter or denial that proves your coverage ended.

3

Compare insurers Rates for the same plan letter can differ a lot between companies.

4

Choose your plan letter Pick from the plans your right allows, such as Plan G or Plan N.

5

Submit on time Apply within your window and request a start date that avoids a gap.

Shopping with a right in hand puts you in a strong position, because every insurer must take you at its standard rate. Use our list of best-rated Medigap insurance companies to narrow your choices.

Bottom Line

The Bottom Line

A guaranteed issue Medicare supplement lets you buy coverage without health questions, but only in set situations and usually within 63 days. Know your trigger, keep your proof, and check whether your state adds year-round or birthday-rule rights.

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Frequently Asked Questions

➤ What does guaranteed issue mean for Medicare Supplement plans?

It means an insurer must sell you a Medigap policy without asking health questions or charging more for your health. It applies only in certain situations set by federal or state law.

➤ How long do I have to use a guaranteed issue right?

In most federal situations, you can apply up to 60 days before your old coverage ends and no later than 63 days after. Trial rights have their own 12-month limits.

➤ Which Medigap plans can I buy with guaranteed issue?

Usually Plans A, B, D, G, K and L. Plans C and F are available only if you were eligible for Medicare before 2020. The trial right at 65 can open more plans.

➤ Is there guaranteed issue for Medicare Supplement plans year-round?

Only in a few states. KFF reports that Connecticut and New York require year-round guaranteed issue, and Massachusetts and Maine have annual windows.

➤ What is the Medigap birthday rule?

It is a state rule that lets current Medigap policyholders switch to another policy each year around their birthday without health questions. Sixteen states have one, including California, Oregon and Illinois.

➤ Can I get guaranteed issue Medigap when leaving Medicare Advantage?

Only if you qualify, such as during a trial right or if your plan leaves your area. Simply switching during the Annual Enrollment Period does not usually create a right.

➤ Does guaranteed issue cover pre-existing conditions?

Yes. When you buy with a guaranteed issue right, the insurer cannot exclude or delay coverage for pre-existing conditions.

➤ What proof do I need for a guaranteed issue right?

Keep the letter, notice or claim denial showing your coverage ended and why. Send a copy with your Medigap application.

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Medicare Supplement Quotes

Call a Licensed Agent Now

Compare Plan G, Plan N and more from several insurance companies in one call.

☎ 1-855-398-0716

TTY users 711  |  Mon–Fri: 5am–7pm, Sat–Sun: 7am–4pm CT

No obligation to enroll

Find & Compare Plans Online

Speak with a licensed insurance agent

1-855-398-0716TTY 711

Mon-Fri: 8am-9pm ET

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