Open Enrollment vs. Guaranteed Issue (GI): What's the Difference?

There’s a lot about Medicare that’s confusing, but we’d wager that nothing has caused as much confusion as the terms Open Enrollment and Guaranteed Issue (GI).

GI and Open Enrollment are so similar... but they’re different. They overlap at times, and it can get downright confusing.

So, if you’d like to understand how Open Enrollment and GI affects you, we’ll explain what they are and how they interact with each other.

Open Enrollment

This means that there’s a federal regulation that exists allowing anyone – regardless of health – to be accepted for any Medicare Supplement.

During open enrollment, you can purchase any plan without having to pass any medical underwriting for 6 months. Keep in mind that this only happens once in your life – when you’re signing up for Medicare Part B for the first time.

If you think you might be in open enrollment, it’s extremely important that you look at Medigap plans. This is especially important if you have a health condition. This is the only time you’ll be able to get any Medigap plan without having to pass medical questions.

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To make things interesting, there are times when you can be in an open enrollment situation while also being in a GI situation.

Guaranteed Issue (GI)

There are also “Guaranteed Issue” (GI) situations, where you can only sign up for Plans A, B, C, or F without having to pass medical underwriting.

People usually only choose Plan F, because it’s the only option with great coverage, but those other plans are also available.

GI situations occur when something happens to your existing insurance. Here are 2 common examples:

• You’re in a Medicare Advantage Plan, and you move out of the plan’s service area.
• Your employer’s group health plan is ending.

In these circumstances, you have a 63-day window to choose a plan.

As you’ve probably guessed, it is possible to be in a GI and open enrollment scenario at the same time.

For example, you might be getting dropped from your employer’s group health plan, so you decide to enroll in Medicare Part B for the first time. Technically, you’re GI and open enrollment.

However, you always want to side with open enrollment, because you can choose any Medigap plan you want with no medical underwriting. That means that even if you’re not that healthy, you can still choose any plan.

There are many situations that straddle the border of “Is this a GI situation or is it Open Enrollment?” Sometimes, we don’t even know for sure!

We are always happy to check for you by contacting the insurance underwriters for you. This is just one of the free services we provide.

And again, if you think you might be in open enrollment, it’s important that you look at Medigap plans. This is especially important if you have a health condition. This is the only time you’ll be able to get any Medigap plan without having to pass medical questions.

Download the Turning 65 Checklist