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Your Rights to Buy a Medigap Policy

California Health Advocates > Medigap > Your Rights to Buy a Medigap Policy

Insurance companies must sell you a Medigap plan at certain times:

  • Open Enrollment Periods
  • Guaranteed-Issue Periods

At other times, insurance companies may refuse to sell you a policy. If you have or had health problems, you may not be able to buy the Medigap plan of your choice unless you are in open enrollment or a guarantee-issue period.

It is important to understand these times because they allow you to get a Medigap plan when a company might otherwise refuse to sell you one (due to your health). If you are relatively healthy, however, you may be able to buy any Medigap policy whenever you want, provided you pass a health screening, if required. Some companies may even sell you a policy without a health screening, unless you have End-Stage Renal Disease (ESRD).

Note: If you have ESRD and you are younger than 65, none of the rights described in the sections below apply. See our fact sheet available via subscription, Medicare and People with End-Stage Renal Disease (ESRD), for more information.

A Note About a New Federal Law: Beginning January 1, 2020 federal law does not allow beneficiaries who have their 65th birthday on or after that date, or who become eligible for Medicare due to a disabling condition, to buy any Medigap plan that covers the Part B deductible. This includes Medigap plans C, F, and high deductible Plan F. Instead, those beneficiaries (except those with ESRD) can buy Medigap plans D, G or high deductible G that don’t include a benefit for the Part B deductible. This is a requirement of federal law to encourage beneficiaries to shoulder more of their own medical costs.

This restriction does not apply to anyone who was eligible for Medicare before 2020. Medigap Plans C, F, and high deductible F can continue to be sold to anyone who was eligible for Medicare before 2020. Companies are required by federal law to continue to make Medigap plans A and C or F, and D or G available in any state where they market Medigap plans.

In this section:

  1. Open Enrollment

  2. Guaranteed Issue

  3. Other Open Enrollment or Guaranteed-Issue Periods Under California Law

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