Medigap plans usually ask you a lot of health questions. Sometimes they turn you down. But once a year, or after certain life events, that changes. You get what is called a guaranteed issue right, and the carriers must sell to you. Here are all seven of these rights and how to use them.
The short answer
A guaranteed issue right is a federal rule that lets you buy a Medigap plan with no health questions, no denial, and no waiting period for pre-existing conditions.
There are 7 federal triggers. Most involve losing other coverage. Each has a strict deadline, usually 63 days. Some states go further and offer more.
What guaranteed issue actually does for you
When you have a guaranteed issue right, Medigap carriers must:
- Sell you a Medigap plan (they cannot deny you)
- Charge you the same standard rate as anyone else your age (they cannot rate you up)
- Cover pre-existing conditions immediately (no waiting period)
They can still:
- Limit which plan letters they must sell you (usually A, B, C, F, K, L, or newer letters D and G)
- Require you to apply within the deadline
It is essentially the same protection you had during your first 6-month Medigap Open Enrollment Period at 65. But triggered by a specific event later on.
The 7 federal guaranteed issue triggers
1. Your Medicare Advantage plan leaves your area or terminates
If your Advantage plan is discontinued, or the plan pulls out of your county, you have a guaranteed issue right. You can enroll in Original Medicare and buy a Medigap plan.
Window: 63 days after coverage ends, or up to 60 days before it ends. You can also enroll starting 60 calendar days before the day your coverage ends.
Plans available: Plan A, B, C, F, K, or L. Since 2020, new Medicare eligibles can get Plan D or Plan G instead of C or F.
2. You moved out of your Medicare Advantage plan's service area
You move and your Advantage plan does not cover the new area. Same rights as above.
Window: 63 days after the move, or from when the plan notifies you.
3. Your employer or union health plan coverage is ending
You had group coverage that supplemented Medicare (retiree health or an employer plan). That coverage ends or is significantly reduced. Guaranteed issue kicks in.
Window: 63 days after employer coverage ends.
Plans available: Any Medigap plan except Plan D, G, M, or N. Since 2020, Plan D or Plan G may be available instead.
4. Your Medigap carrier goes bankrupt or misled you
Your current Medigap company is going out of business, or you can prove the carrier misled you. You get to switch to another Medigap plan without underwriting.
Window: 63 days after coverage ends or misrepresentation is discovered.
5. You dropped a Medigap plan for the first time to try Medicare Advantage
This is the classic "trial right." You had Medigap. You dropped it to try Medicare Advantage for the first time. Now, within 12 months, you can go back and buy the same Medigap plan you had before.
Window: 12 months from when Medicare Advantage coverage started.
Plans available: The exact plan letter you had before, from the same carrier if available. If not, the same plan letter from a different carrier.
6. You joined Medicare Advantage at age 65 and want to switch back
This is the other trial right. When you first became eligible for Medicare at 65, you signed up for Advantage instead of Original Medicare + Medigap. Within 12 months, you can drop the Advantage plan, enroll in Original Medicare, and buy any Medigap plan sold in your state.
Window: 12 months from initial Medicare eligibility.
Plans available: Any Medigap plan.
7. Your Medicare Select plan gets discontinued or you move out of its area
Medicare Select is a Medigap plan variant that uses a network. If the network shuts down or you move out, you can switch to standard Medigap.
Window: 63 days.
How the trial right actually works
The two trial rights (numbers 5 and 6 above) are the most useful for people already on Medicare. Here is a real example.
Bob, 66, chose Medicare Advantage when he first joined Medicare last year. He liked the $0 premium. But his oncologist just referred him to a specialist who is out of network. His Advantage plan won't cover it fully.
Bob is 11 months into his Advantage coverage. He can use trial right #6:
- Enroll in Original Medicare (he can drop Advantage during a Medicare Advantage Open Enrollment Period, January 1 to March 31, or use a Special Enrollment Period)
- Apply for any Medigap plan sold in his state, with no health questions
- Get Part D drug coverage
- See the specialist without network restrictions
If Bob waits past the 12-month mark, he loses the trial right. He would then have to answer health questions. His cancer diagnosis would probably get him denied.
What plans you can buy under guaranteed issue
The specific Medigap plans you can buy vary by trigger. Broadly:
| Trigger | Plans you can buy |
|---|---|
| Loss of Medicare Advantage (moving, plan leaves) | A, B, C, F, K, L (or D, G if newly Medicare eligible since 2020) |
| Loss of employer/retiree coverage | A, B, C, F, K, L (or D, G if newly Medicare eligible since 2020) |
| Trial right (dropping first Medigap for Advantage) | The exact same plan letter you had |
| Trial right (at first Medicare eligibility) | Any Medigap plan sold in your state |
Plan G is the most practical choice today for most people. It offers the strongest coverage available to anyone new to Medicare since 2020.
The pre-2020 vs post-2020 Medicare rule
Plan C and Plan F are no longer sold to anyone who first became eligible for Medicare on or after January 1, 2020. If that is you:
- Instead of Plan C, you get Plan D as a guaranteed issue option
- Instead of Plan F, you get Plan G
See our Plan F vs Plan G explanation for more.
State guaranteed issue rules that go beyond federal
Some states add extra guaranteed issue rules. Highlights:
- California, Oregon, Idaho, Illinois, Kentucky, Louisiana, Maryland, Nevada, Oklahoma, Washington: Birthday rule allows annual switching without underwriting
- Missouri: Anniversary rule
- Connecticut, New York: Year-round guaranteed issue on all Medigap plans
- Massachusetts: Annual open enrollment window
- Maine: Limited annual issue for Plan A
See our Medicare birthday rule state-by-state guide and how to switch Medigap without underwriting.
What guaranteed issue does NOT do
Common misconceptions:
- It does NOT let you switch Medigap plans just because you want a lower premium
- It does NOT let you shop the whole market freely (usually limits which plans qualify)
- It does NOT last forever (63 days on most triggers)
- It does NOT force carriers to sell you specific plan letters they do not offer in your state
- It does NOT waive any prescription drug coverage rules (Part D is separate)
How to prove you have a guaranteed issue right
Save your paperwork. Carriers ask for proof. You will typically need:
- Letter from your former plan showing coverage end date (Advantage or employer plan)
- Notice from your Medicare Advantage plan of termination
- Letter documenting your move out of a service area
- Documentation of your Medicare eligibility date (for trial rights)
Keep everything. Send copies to the new Medigap carrier with your application.
Real example: retiring at 68
Sarah is 68 and retiring after 30 years of teaching. Her employer group plan ends June 30. She wants Original Medicare + Medigap.
Her guaranteed issue right kicks in the day her group coverage ends. She has 63 days to apply for a Medigap plan.
Steps:
- Get a letter from her employer confirming the end date of coverage
- Enroll in Medicare Part B (Special Enrollment Period because she is losing employer coverage)
- Apply for Medigap Plan G with no health questions
- Enroll in a Part D drug plan
Sarah gets the plan without underwriting. She saves months of stress and possibly a denial due to her diabetes.
Common mistakes
Waiting until after coverage ends to apply
You can apply up to 60 days before your other coverage ends. Do that. Do not wait.
Not asking about the trial right
Many people who signed up for Medicare Advantage at 65 do not know they can switch to Medigap in the first year without health questions.
Missing the 63-day window
Set a calendar reminder as soon as you know a trigger event is coming.
Assuming you can pick any Medigap plan
Most triggers limit you to a subset. The trial right at first Medicare eligibility is the exception where you can pick any plan.
Not saving documentation
Keep letters, notices, and dates. You will need them when you apply.
Where to check the details for your situation
The federal source is Medicare.gov guaranteed issue rights. Your State Health Insurance Assistance Program (SHIP) offers free help figuring out which rules apply in your state.
The bottom line
Guaranteed issue rights are a safety net for people losing coverage. Seven federal triggers, mostly 63-day windows, mostly limited to certain plan letters. Some states add more protections.
If you have any of these coming up (retiring, moving, plan discontinued, first year on Medicare Advantage) do not wait. Apply for Medigap during the window. It is often the last time you can get the plan you want without medical underwriting.
Not sure if you qualify for one of these rights? Book a free call. We will walk through your situation and file the paperwork within the window.
Frequently asked questions
What is a Medicare guaranteed issue right?
A federal rule that lets you buy Medigap without health questions after specific life events like losing other coverage.
How long do I have to use my guaranteed issue right?
Most windows are 63 days after coverage ends, and some let you apply up to 60 days before. Miss the window and you lose the right.
What is the Medicare Advantage trial right?
If you tried Advantage when first eligible for Medicare, you have 12 months to switch back to Original Medicare + any Medigap plan with no underwriting.
Which Medigap plans can I buy with guaranteed issue?
Usually A, B, C, F, K, or L. If you became Medicare eligible after Jan 1, 2020, Plan D or Plan G replaces C and F. The trial right at first eligibility opens all plans.
Do guaranteed issue rights apply if I want to switch Medigap plans?
Usually no. Federal guaranteed issue is for losing coverage, not shopping. Some states like California and Oregon have annual switch rights (birthday rule).