Can a Medicare supplement insurance company deny me coverage?

The answer is yes.  It is possible to be denied for coverage when applying for a new Medicare supplement policy. 

But during certain times in your life you cannot be denied.  So it depends.  Let’s look at a few cases where they cannot deny you coverage.

Open Enrollment period

Are you just starting Medicare?  Then you are in your Open Enrollment period.  This is the 6 month window around when you turn 65 and enroll in Medicare part B. 

Insurance companies are not allowed to ask any health questions for your Medicare supplement policy during this window.

That means they cannot charge you a different premium due to your health history.  And they also cannot deny you based of your health history. 

Those 2 reasons are why it’s very important to make a selection during this window that you are comfortable with for many years.

Guaranteed Issue

Another case where insurance companies cannot rate you differently or deny you coverage is when you fall into a Guarantee Issue scenario.  

There are several of these cases but 2 common ones are

• When you move outside of your plan’s geographic service area
• Your employer group health plan ends some or all of your coverage

The first is a situation where you have current Medicare coverage and move out of that plan’s service area.  Your insurance company will notify you and send a cancellation letter because they are not able to provide you with coverage.

That letter gives you a limited time frame to get a new plan without having to pass an underwriting review.

The second situation is common because more people continue to have group health coverage past the age of 65.  It could be because they are still working.  Or because their spouse is still working.  Either way it doesn’t impact the next steps.

When that coverage ends you will have a limited time opportunity to enroll in a new Medicare supplement policy without having to pass underwriting review.

There are other options but these are two of the more common scenarios.  If you have questions about your situation it may be best to discuss with a Medicare focused insurance agent.

Underwriting

If you don’t fall into one of those first two buckets then you will need to pass an underwriting review. Which means you could potentially be denied for coverage.  Or your premium could be higher due to your health history.

There are around 40 Medicare supplement carriers in Wisconsin.  And they all have different rules for underwriting.

So just because you have been denied by one company does not mean all companies will deny your Medicare supplement application.

It’s helpful to speak with an independent agent that can help you with multiple carriers so they can help you find a company that is likely to accept your application. 

Want to change your Medicare supplement?

There’s around 40 Medicare supplement carriers in Wisconsin.

There are a few options for you to change your plan:

1. You could contact each one and read their underwriting guide to see if you qualify.  Most people don’t find underwriting guides to be the most exciting reading material
2. Call one company at a time and apply, until you are accepted.  It sure seems like there are better things to do each day then call 1-800 numbers
3. Contact an independent agent that represents multiple companies and let them work on your behalf (after all the help is free)

Being denied from a carrier isn’t the end of the world. There may still be options.

Some states have other rules giving you additional chances to make a change but Wisconsin does not.

If you have other questions please don’t hesitate to reach out.

Mike Lovell

Mike@askMedicareMike.com

608-571-4461

Still have questions on Wisconsin Medicare Supplements and what your other options are?