Primary sources & receipts for this page
Every factual claim on this page carries a “source” button that opens the exact quote and primary link from Medicare.gov, the Electronic Code of Federal Regulations (eCFR), the United States Code, shiphelp.org, or our published site terms.
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63-day Medigap guaranteed-issue window (starts up to 60 days before coverage ends)
“...no later than 63 calendar days from the date your coverage ends.”
CMS / Medicare.gov Publication No. 02110, Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare (and 42 U.S.C. § 1395ss(s)(3)(E), setting the statutory window ending “63 days after the applicable notice” / termination).
medicare.gov/health-drug-plans/medigap/ready-to-buy/when · medicare.gov/publications/02110-medicare-and-medigap-policies.pdf · 42 U.S.C. § 1395ss(s)(3)(E)
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Free official help at Medicare.gov (1-800-MEDICARE) and SHIP (shiphelp.org)
“1-800-MEDICARE (1-800-633-4227) TTY users can call 1-877-486-2048”
Medicare.gov, “Talk to someone”
“State Health Insurance Assistance Programs: Local Medicare Help”
State Health Insurance Assistance Program National Technical Assistance Center (shiphelp.org)
medicare.gov/talk-to-someone · shiphelp.org
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Definition of a Third-Party Marketing Organization (TPMO) under 42 CFR § 422.2260
“Third-party marketing organization (TPMO) means organizations and individuals, including independent agents and brokers, who are compensated to perform lead generation, marketing, sales, and enrollment related functions as a part of the chain of enrollment (the steps taken by a beneficiary from becoming aware of an MA plan or plans to making an enrollment decision).”
Money You’re Owed is an independent educational publisher and receives no compensation from any insurer, plan, agent, or broker, and performs no lead generation, marketing, sales, or enrollment functions for any plan.
eCFR: 42 CFR § 422.2260
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Involuntary Medicare Advantage termination triggers federal Medigap guaranteed-issue rights
“The individual is enrolled with a Medicare+Choice organization under a Medicare+Choice plan under part C, and there are circumstances permitting discontinuance of the individual's election of the plan under the first sentence of section 1395w–21(e)(4) of this title.”
42 U.S.C. § 1395ss(s)(3)(B)(ii) (applicable to Medicare Advantage plans under Part C)
42 U.S.C. § 1395ss(s)(3)(B)(ii) · medicare.gov/health-drug-plans/medigap/ready-to-buy/when
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Federal guaranteed-issue Medigap plan letters after involuntary termination (Plan N excluded)
“Subject to clauses (ii) and (iii), a medicare supplemental policy described in this subparagraph is a medicare supplemental policy which has a benefit package classified as ‘A’, ‘B’, ‘C’, or ‘F’ (including the benefit package classified as ‘F’ with a high deductible feature, as described in subsection (p)(11)), under the standards established under subsection (p)(2), or a benefit package described in subparagraph (A) or (B) of subsection (w)(2) and that is offered and is available for issuance to new enrollees by such issuer;”
42 U.S.C. § 1395ss(s)(3)(C)(i); combined with § 1395ss(w) (Plans K and L) and § 1395ss(z)(4) (substituting Plans D and G, including High-Deductible G, for Plans C and F for individuals newly eligible on or after January 1, 2020). CMS Publication No. 02110 summarizes the federal list as: “Plan A, B, C, D, F, G, K, or L”. Plan N is not included in 42 U.S.C. § 1395ss(s)(3)(C)(i).
42 U.S.C. § 1395ss(s)(3)(C)(i) · CMS Pub. No. 02110 (PDF)
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Plans C and F limited to beneficiaries eligible before January 1, 2020; Plans D and G substituted for newer enrollees
“Notwithstanding any other provision of this section, on or after January 1, 2020, a medicare supplemental policy that provides coverage of the part B deductible ... may not be sold or issued to a newly eligible Medicare beneficiary.” “In the case of a newly eligible Medicare beneficiary, except as the Secretary may otherwise provide, any reference in this section to a medicare supplemental policy which has a benefit package classified as ‘C’ or ‘F’ shall be deemed, as of January 1, 2020, to be a reference to a medicare supplemental policy which has a benefit package classified as ‘D’ or ‘G’, respectively.”
42 U.S.C. § 1395ss(z)(1), (z)(4)
42 U.S.C. § 1395ss(z)
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Benefit packages K and L included in statutory guaranteed-issue list
“(A) First new benefit package (Plan K)... (B) Second new benefit package (Plan L)...”
42 U.S.C. § 1395ss(w)(1)(A)–(B), cross-referenced by 42 U.S.C. § 1395ss(s)(3)(C)(i)
42 U.S.C. § 1395ss(w)
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First-year Medicare Advantage “Trial Right” vs. involuntary plan termination
“You joined a Medicare Advantage Plan or Program of All-inclusive Care for the Elderly (PACE) when you were first eligible for Medicare Part A at 65, and within the first year of joining, you decide you want to switch to Original Medicare. (Trial right).” “You have the right to buy... Any Medigap policy that's sold by an insurance company in your state.”
Medicare.gov / CMS Publication No. 02110 (implementing 42 U.S.C. § 1395ss(s)(3)(B)(v) & (C)(ii))
CMS Pub. No. 02110 (PDF) · 42 U.S.C. § 1395ss(s)(3)(B)(v)
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Written non-renewal notice required at least 90 calendar days before year-end
“If an MA organization does not intend to renew its contract, it must notify— ... (ii) Each Medicare enrollee by mail at least 90 calendar days before the date on which the nonrenewal is effective.”
42 CFR § 422.506(a)(2)(ii)
eCFR: 42 CFR § 422.506(a)(2)(ii)
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Annual Medicare Open Enrollment Period (October 15 – December 7)
“October 15 – December 7” · “Open Enrollment”
Medicare.gov, “Joining a health or drug plan”
medicare.gov/basics/get-started-with-medicare/get-more-coverage/joining-a-plan
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Special Enrollment Period when a Medicare Advantage plan leaves your area (December 8 – last day in February)
“CMS or the organization has terminated the organization's contract for the plan, discontinued the plan in the area in which the individual resides, or the organization has notified the individual of the impending termination of the plan, or the impending discontinuation of the plan in the area in which the individual resides.”
42 CFR § 422.62(b)(1)
“Between December 8 and the last day in February of the following year.”
Medicare.gov, “Special Enrollment Periods”
eCFR: 42 CFR § 422.62(b)(1) · medicare.gov Special Enrollment Periods
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Default return to Original Medicare if no new Medicare Advantage plan is elected
“Such an individual who fails to make an election during such period is deemed to have chosen to change coverage to the original medicare fee-for-service program option described in subsection (a)(1)(A).”
42 U.S.C. § 1395w-21(e)(4)
42 U.S.C. § 1395w-21(e)(4)
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Keeping copies of termination notices as proof for your Medigap application
“Keep any letters, notices, emails or claim denials from your previous coverage, in case you need to prove your coverage ended.”
Medicare.gov / CMS Publication No. 02110
medicare.gov/health-drug-plans/medigap/ready-to-buy/when · CMS Pub. No. 02110 (PDF)
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What Medigap guaranteed-issue rights protect
“Limited situations when insurance companies must sell you certain Medigap policies, cover your pre-existing health conditions, and can't charge you more because of health problems.”
Medicare.gov, “When can I buy a Medigap policy?”
medicare.gov/health-drug-plans/medigap/ready-to-buy/when
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Medigap requires returning to Original Medicare
“It's illegal for someone to sell you a Medigap policy if you have a Medicare Advantage Plan, unless you're switching back to Original Medicare.”
Medicare.gov, “Illegal Medigap practices”
medicare.gov/health-drug-plans/medigap/ready-to-buy/how/illegal-practices
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Medigap policies sold after 2005 exclude prescription drugs; separate Part D plan needed
“Medigap plans sold after 2005 don't include prescription drug coverage. If you want prescription drug coverage, you can join a separate Medicare drug plan (Part D).”
Medicare.gov, “Medigap & prescription drug coverage”
medicare.gov/health-drug-plans/medigap/basics/coverage
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Money You’re Owed Terms of Service, “Pricing and payment”
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30-day money-back guarantee by email
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Money You’re Owed Terms of Service, “Refunds”
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Educational content only; not insurance, legal, or medical advice
“Everything published and sold is for general education. It is not financial, legal, tax, or professional advice, and creates no client or advisory relationship.”
Money You’re Owed Terms of Service, “Educational content only”
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Stripe processes payments; card numbers are not stored by Money You’re Owed
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Money You’re Owed Privacy Policy, “What we collect”