Learn → Loss of group coverage
Losing employer or union health coverage
If your employer or union group health plan ends, or you involuntarily lose group coverage that you had through your spouse, federal law re-opens a guaranteed-issue Medigap window. This protection is one of the most commonly-applicable federal qualifying events — and it’s especially relevant for the surviving-spouse cohort losing employer-via-spouse coverage.
When the protection applies
The federal protection re-opens a guaranteed-issue Medigap window when:
- Your employer or union group health plan ends
- Your group coverage ends because you no longer qualify (e.g., you retire and the retiree-coverage isn’t equivalent)
- The group coverage you had through your spouse ends because of the spouse’s death, divorce, retirement, or job loss
- The group plan reduces or terminates the prescription drug benefit such that it’s no longer creditable
Window timing
The window typically begins no later than 63 days before the date your group coverage ends, and runs for 63 days aftercoverage ends. During that window, you may apply for a Medigap policy with federal guaranteed-issue rights — insurers cannot deny you, charge a higher premium based on your health, or require medical underwriting. If you let the 63-day post-coverage window close without applying, the federal guaranteed-issue right is gone.
Which Medigap plans you may buy under this protection
Under federal law, the loss-of-group-coverage protection generally entitles you to buy any Medigap policysold by any insurer in your state that the insurer offers in your state — with some federally-defined exceptions for the most-comprehensive plans. The SHIP counselor below can confirm the exact federally-protected plan list for your specific situation.
Federal Medigap protection on loss of group coverage
Last verified:Source:medicare.gov — When can I buy a Medigap policy? (Guaranteed issue rights)
If you’re a recently-bereaved surviving spouse
Losing employer-via-spouse coverage on the death of a spouse is one of the most common applications of this federal protection. The 63-day window starts running as soon as the group coverage ends. We say this carefully because the audience for this page often arrives in active grief: your state SHIP counselor can navigate this with you, including the timing and the documentation requirements. They are free, federally funded, and not a broker.