Medicare Supplement Underwriting Guidelines – What You Need to Know

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Medicare supplement insurance plans use medical underwriting to screen potential applicants. While pre-existing conditions are not as big of a concern with Medigap plans as they are with under-65 health insurance, this type of plan does approve or deny an applicant based on their health (with some exceptions – see below). So, when you apply for a Medicare supplement or when you are comparing plans, you need to endeavor to understand the differences in medical underwriting from company to company.

Typically, Medicare supplement underwriting questions are very similar. Companies, in nearly almost all cases, ask about things like COPD, heart attacks, strokes, cancer, hospital or nursing facility confinement, etc. Most companies also ask for a list of your current medications to determine your eligibility will be.

There are some very important, notable exceptions to the general underwriting guidelines. These exceptions are called ‘guaranteed issue’ and ‘open enrollment’. Guaranteed issue is when you receive approval into a Medicare supplement plan with no medical questions asked at all. You qualify for guaranteed issue when you are losing some other type of coverage, like employer coverage or a Medicare Advantage plan, when you move to a new state, or one of several other instances. Open enrollment occurs for Medicare supplement plans when you are BOTH age 65 and enrolled in Medicare Part B. For most people, this is the first day of the month that you turn 65 through 6 months from that date. During this time, you also do not have to answer medical questions on the application, regardless of plan or company that you choose.

Underwriting guidelines for Medicare Supplements vary greatly from company to company. It is very important to know what different companies look for when underwriting an application. This can help prevent an unnecessarily declined application and make for a smoother overall process. The most effective way to get this information is to work with an independent agent who is familiar with the different underwriting guidelines from all the different companies. They can help you evaluate which companies are more stringent on underwriting and which companies would be the best fit for you. If you are in good health, it may be to your advantage to be with a company that is more stringent than others, since on average, the people with that company may be healthier (can lead to fewer claims and fewer rate increases).

If you would like more information or to get Medicare supplement insurance underwriting information, please contact us on our website at Medigap quotes.


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