Client: What does evidence of insurability mean?
Coach: It means you must show proof that you are eligible to apply for coverage. When one is first eligible for Medicare, there is a window of opportunity to apply for Part B (doctors), and Medicare Supplement insurance without evidence of insurability. This window occurs during a 7-month period called your initial enrollment period beginning 3 months before the month you turn age 65, includes the month you turn age 65, and ends 3 months after the month your turn age 65.
If you enroll during your initial enrollment period, you are guaranteedentry into Medicare withouut evidence of insurability meaning you get the coverage regardless of your existing health conditon, with the exception of End Stage Renal disease. Special rules apply for End Stage Renal disease. Visit your local Social Security office for details.
If you do not enroll during your initial election period when you turn age 65, and choose to stay on your employer group health plan, or if you are a spouse who is also insured on the plan, you are not required to enroll in Part B, and your 7-month guaranteed insurability window is protected, until you decide to leave the group plan. It’s best to enroll in Part B one month prior to the month that your leave the group plan. Your 7-month guaranteed insurability status begins the month after you leave the group plan.
Always know when you have guaranteed insurability status. Some beneficiaries do not know that if they leave Original Medicare and join a Medicare Advantage plan, there guaranteed insurability status is only protected for 12 months. If after 12 months, they decide to return to Original Medicare, and have health issues, they may not be able to return, and may only have the option available to switch to another Advantage plan.
