Kentucky

Federal “guaranteed-issue” protections may re-open a Medigap window for specific qualifying events

Even after your federal 6-month Medigap Open Enrollment Period closes, federal law (per 42 U.S.C. § 1395ss and CMS regulations) re-opens a guaranteed-issue Medigap window for several qualifying events. During a guaranteed-issue window, insurers cannot deny you a Medigap policy based on health, charge a higher premium based on health, or require medical underwriting.

• Loss of group employer coverage

  If your employer or union health plan ends or you involuntarily lose your group coverage (including coverage you had through your spouse), federal law re-opens a guaranteed-issue window for Medigap. The window typically begins no later than 63 days before the date your group coverage ends and runs for 63 days after the coverage ends.

• Medicare Advantage trial right (first 12 months)

  If you joined a Medicare Advantage plan when you first became eligible for Medicare at age 65, and you decide within the first 12 months of MA enrollment that you'd rather have Original Medicare with a Medigap policy, federal law gives you a guaranteed-issue right to buy any Medigap policy sold by any insurer in your state.

• Medicare Advantage plan termination or service-area reduction

  If your Medicare Advantage plan leaves the Medicare program, ends coverage in your area, or you move out of the plan's service area, federal law gives you a guaranteed-issue right to certain Medigap policies.

• Loss of Medicaid (in certain configurations)

  If you had a Medicare Supplement Select policy and you move out of its service area, OR if certain Medicaid-related coverage transitions occur, federal guaranteed-issue rights may apply. Verify your specific situation with your state SHIP counselor — eligibility is fact-specific.

• Insurer bankruptcy or fraud-related coverage end

  If your Medigap insurance company goes bankrupt and you lose coverage, or if you lose Medigap coverage through no fault of your own (including misrepresentation by the insurer), federal law re-opens a guaranteed-issue window.