Can You Be Denied A Medicare Supplement Plan?

You can be denied a Medicare supplement plan in some circumstances. If you try to buy a Medigap policy during your Medigap open enrollment period, then you should not be able to be denied. But you can be rejected if you delay enrollment and apply at any point later in your life, due to a preexisting health condition.

Christian Simmons, writer and researcher for RetireGuide
  • Written by
    Christian Simmons

    Christian Simmons

    Financial Writer

    Christian Simmons is a writer for RetireGuide and a member of the Association for Financial Counseling & Planning Education (AFCPE®). He covers Medicare and important retirement topics. Christian is a former winner of a Florida Society of News Editors journalism contest and has written professionally since 2016.

    Read More
  • Edited By
    Lamia Chowdhury
    Lamia Chowdhury, editor for RetireGuide.com

    Lamia Chowdhury

    Financial Editor

    Lamia Chowdhury is a financial content editor for RetireGuide and has over three years of marketing experience in the finance industry. She has written copy for both digital and print pieces ranging from blogs, radio scripts and search ads to billboards, brochures, mailers and more.

    Read More
  • Published: August 17, 2022
  • Updated: September 20, 2022
  • 4 min read time
  • This page features 5 Cited Research Articles
Fact Checked
Fact Checked

Our fact-checking process starts with vetting all sources to ensure they are authoritative and relevant. Then we verify the facts with original reports published by those sources, or we confirm the facts with qualified experts. For full transparency, we clearly identify our sources in a list at the bottom of each page.

Cite Us
How to Cite RetireGuide.com's Article

APA Simmons, C. (2022, September 20). Can You Be Denied A Medicare Supplement Plan? RetireGuide.com. Retrieved September 29, 2022, from https://www.retireguide.com/medicare/supplement-insurance/can-you-be-denied/

MLA Simmons, Christian. "Can You Be Denied A Medicare Supplement Plan?" RetireGuide.com, 20 Sep 2022, https://www.retireguide.com/medicare/supplement-insurance/can-you-be-denied/.

Chicago Simmons, Christian. "Can You Be Denied A Medicare Supplement Plan?" RetireGuide.com. Last modified September 20, 2022. https://www.retireguide.com/medicare/supplement-insurance/can-you-be-denied/.

Why Trust RetireGuide.com
Why You Can Trust Us

Content created by RetireGuide and sponsored by our partners.

Key Principles

RetireGuide’s mission is to provide seniors with resources that will help them reach important financial decisions that affect their retirement. Our goal is to arm our readers with knowledge that will lead to a healthy and financially sound retirement.

We’re dedicated to providing thoroughly researched Medicare information that guides you toward making the best possible health decisions for you and your family.

RetireGuide LLC has partnerships with Senior Market Sales (SMS), GoHealth and others.

Our partners are able to be reached through the phone numbers and/or forms provided on our website.

The content and tools created by RetireGuide adhere to strict Medicare and editorial guidelines to ensure quality and transparency.

Editorial Independence

While the experts from our partners are available to help you navigate various Medicare plans, RetireGuide retains complete editorial control over the information it publishes.

We operate independently from our partners, which allows the award-winning RetireGuide team to provide you with unbiased information.

Visitors can trust our inflexibility regarding our editorial autonomy. We do not allow our partnership to influence RetireGuide’s editorial content whatsoever.

Can You Be Denied Based on When You Applied?

You can be denied a Medicare supplement plan based on when you originally applied.

It’s important to be aware of when you are first eligible for a Medigap policy and how long you will have to enroll in one before you reach a point where you can be denied.

Remember that there are some differences in when you can be denied by each state.

Open Enrollment Period

You typically cannot be denied a policy if you are enrolling during your Medigap open enrollment period.

This period lasts for six months and begins the first month that you have Medicare Part B coverage. Even if you have an existing health condition or another extenuating factor, you cannot be denied a Medigap policy at this stage.

Your best bet if you expect to need supplemental insurance is to sign up for it when you first become eligible to avoid any potential issues, gaps in coverage or denials in the future.

Even if you do not currently have a health condition that could lead to you being denied coverage after your initial enrollment period, that may not be the case in the future.

Delayed Enrollment

This is the area where you could potentially run into issues when trying to secure a Medigap policy. If you don’t purchase one during your Medigap open enrollment, then insurance companies can choose to reject you for essentially any reason.

The exception to this would be if you experience a qualifying event or a special circumstance that is specified under Medigap protections. This includes scenarios such as if you have Medicare Advantage and you move out of the plan’s area or if you had employer health coverage paired with Original Medicare that is ending.

In these circumstances, an insurance company cannot deny you a Medigap plan regardless of any existing health issues or other scenarios.

Can You Be Denied for Health Issues?

For most of the United States, you can be denied a Medicare supplement plan due to pre-existing health issues.

According to the Kaiser Family Foundation, this is true for all but four states. In Connecticut, Maine, Massachusetts and New York, insurance companies must continuously offer Medigap policies to those 65 years or older, or at least offer them for one month out of each year.

But in the rest of the country, an insurance company can choose to deny you based on a health condition. There is no set rule on what health conditions will or won’t lead to a rejection, but things such as heart disease, cancer or other chronic conditions could result in a denial.

Why Would Your Policy Renewal Be Denied?

Once you have a policy, it typically must be renewed since it is a guaranteed renewable policy.

But there are some — typically avoidable — reasons that a policy renewal may be denied.

According to the U.S. Centers for Medicare and Medicaid Services, your policy can be terminated if you stop paying your premiums. This can also happen if it is discovered that you lied or gave inaccurate information on your application.

Your renewal may also be denied if the insurance company that provides the policy goes bankrupt or ceases operations.

These situations are largely avoidable as long as you do your due diligence when first applying. Make sure to double check that all of the information you are providing is completely accurate.

You should also be sure that you can afford a Medigap policy before enrolling, since you will lose the policy if you fail to pay your premiums.

What Should You Do If You’re Denied a Supplement Plan?

If you are denied a supplement plan, the first thing you should do is check your Medicare guaranteed issue rights. You should make sure that the denial was not a mistake or not legal and that none of your rights were infringed upon.

Remember that you cannot be denied a policy if your circumstance meets any of the Medigap protections requirements.

Other than that, there really isn’t much that you can do as far as getting the plan that you wanted. You could look at other Medigap plans provided by other insurance companies and try to apply, but you may run into the same issues especially if you are being denied over a health condition.

Since supplemental insurance is meant to be paired with Original Medicare, you could also look into Medicare Advantage if you are denied. Medicare Advantage plans must include everything that is covered under Original Medicare but often include additional benefits or coverage.

It may be a viable second option if you can’t secure a Medigap policy.

Last Modified: September 20, 2022

5 Cited Research Articles

  1. U.S. Centers for Medicare & Medicaid Services. (2022, March). 2022; Choosing a Medigap Policy: A Guide to Health Insurance for People With Medicare. Retrieved from https://www.medicare.gov/sites/default/files/2022-03/02110-medigap-guide-health-insurance.pdf
  2. Kaiser Family Foundation. (2018, July 11). In All But Four States, Seniors on Medicare Can Be Denied A Medigap Policy Due To Pre-Existing Conditions, Except During
  3. Specified Windows of Opportunity. Retrieved from https://www.kff.org/medicare/press-release/in-all-but-four-states-seniors-on-medicare-can-be-denied-a-medigap-policy-due-to-pre-existing-conditions-except-during-specified-windows-of-opportunity/
  4. U.S. Centers for Medicare & Medicaid Services. (n.d.). Dropping or losing Medigap. Retrieved from https://www.medicare.gov/supplements-other-insurance/when-can-i-buy-medigap/dropping-or-losing-medigap
  5. U.S. Centers for Medicare & Medicaid Services. (n.d.). Guaranteed issue rights. Retrieved from https://www.medicare.gov/supplements-other-insurance/when-can-i-buy-medigap/guaranteed-issue-rights