If your employer or retiree coverage is ending, or your Medicare Advantage plan sent you a letter saying it is leaving, you are probably staring down a 63 day clock that most people in Daytona Beach don’t even know exists. This guide is for you.
The biggest fear I hear from clients in Volusia County is that their health history will keep them out of a good Medicare Supplement plan. They worry a past heart procedure or diabetes will get them turned down. Medicare Supplement guaranteed issue rights, often called Medigap protections, are the legal shield that prevents that, as long as you use them correctly and on time.
Table of Contents
- Guaranteed Issue vs Open Enrollment vs Underwriting
- What Are Medicare Supplement Guaranteed Issue Rights?
- Common Guaranteed Issue Situations and the Plans You Can Get
- Which Plans Can You Get? (And the Plan N Caveat)
- The 63 Day Clock: How to Count It
- Florida Notes: Group Coverage, No Birthday Rule, Moving
- Document Checklist
- If Your Window Has Closed
- Frequently Asked Questions
The Stress of Losing Long Term Coverage
Imagine you’ve worked for the same company for 30 years. You’re 67, you’ve been on the company’s group plan, and you finally decide to retire. You need to move to Medicare, but you’ve had some health issues over the last few years.
You want a Medicare Supplement (Medigap) plan so you can see any doctor in the country who takes Medicare, but you’re worried about the health questions. This is where most people freeze. They stay on expensive COBRA or rush into a plan they don’t really want. In many cases, losing that coverage is exactly what gives you a right to buy a Medigap plan without health questions.
Guaranteed Issue vs Open Enrollment vs Underwriting
There are three ways to buy a Medigap plan. Knowing which lane you are in is half the battle.
| Lane | When it applies | Health questions? | Which plans |
|---|---|---|---|
| Medigap Open Enrollment | The six months starting when you are 65 or older and enrolled in Part B | No | Any Medigap plan sold in Florida |
| Guaranteed issue right | Specific situations, like employer coverage ending or your Medicare Advantage plan leaving | No | Only certain plans (see below) |
| Medical underwriting | Any other time | Yes, and the company can decline you | Any plan, if approved |
None of these are the Annual Enrollment Period in the fall. That window is for Medicare Advantage and Part D plans, not Medigap. If you are turning 65, start with my turning 65 guide for Volusia County.
What Are Medicare Supplement Guaranteed Issue Rights?
In the world of Medicare insurance plans, your health usually matters when you apply for a Supplement outside your Open Enrollment. Guaranteed issue rights are specific situations where insurance companies must sell you certain Medigap policies. When you have one:
- The company must sell you an eligible plan.
- The company cannot charge you more because of past or present health problems.
- The company must cover your pre-existing conditions.
Common Guaranteed Issue Situations and the Plans You Can Get
These are the situations Medicare lists that I see most often in the Daytona Beach area:
| Your situation | Plans you can buy | When to apply |
|---|---|---|
| Your Medicare Advantage plan is leaving your area or stopping service, or you move out of its service area | A, B, C, D, F, G, K or L | As early as 60 days before your coverage ends, and no later than 63 days after |
| Your employer or union coverage that pays after Medicare is ending | A, B, C, D, F, G, K or L | No later than 63 days after the latest of: the date coverage ends, the date on the notice, or the date on a claim denial |
| You joined a Medicare Advantage plan when you first got Medicare at 65, and you leave within the first 12 months (trial right) | Any Medigap policy sold in Florida | As early as 60 days before your Medicare Advantage coverage ends, and no later than 63 days after |
| You dropped a Medigap policy to try Medicare Advantage for the first time, and you leave within 12 months (trial right) | Your old policy if the company still sells it, or A, B, C, D, F, G, K or L | As early as 60 days before your Medicare Advantage coverage ends, and no later than 63 days after |
| Your Medigap company goes bankrupt, or your Medigap or Medicare Advantage plan misled you or broke the rules | A, B, C, D, F, G, K or L | No later than 63 days after your coverage ends |
About Plans C and F: you can only buy Plan C or Plan F if you were eligible for Medicare before January 1, 2020. If you became eligible on or after that date, your choices in these situations include Plans D and G instead.
If your Medicare Advantage plan is ending for 2027, read my step by step guide on what to do when your Medicare Advantage plan is leaving in 2027.
Which Plans Can You Get? (And the Plan N Caveat)
You don’t get to pick any plan on the market. In most guaranteed issue situations, your choices are Plans A, B, C, D, F, G, K and L, with C and F only if you were eligible for Medicare before 2020.
Plan N is not on that list. Plan N is popular because of its lower premium, but in most guaranteed issue situations a company does not have to sell it to you without health questions. The exception is the trial right for people who joined a Medicare Advantage plan when they first got Medicare at 65. In that one case, you can buy any Medigap policy sold in Florida, including Plan N.
For most of my clients who became eligible after 2020, Plan G is the most complete plan available under guaranteed issue. If you are torn between plans, see my full Plan G vs Plan N comparison for Florida.
The 63 Day Clock: How to Count It
For most of these situations, you have 63 days after your coverage ends to apply. In some cases, like a Medicare Advantage plan leaving, you can apply as early as 60 days before it ends, and I recommend that. Applying early lets your new Medigap plan start the day your old coverage stops, with no gap.
If you miss the window, the protection is gone, and you are back to health questions. I have seen clients wait until day 70 because they were busy with a move or retirement paperwork. Please don’t wait until day 60.
Florida Notes: Group Coverage, No Birthday Rule, Moving
- Florida’s group coverage window. Florida law (section 627.6741, Florida Statutes) gives you an open enrollment window of 2 months after your employer group health coverage ends. This is a Florida protection on top of the federal rights above, and the rules on which plans apply can differ, so call me before you count on it.
- Under 65 on Medicare. Florida law also gives people under 65 who have Medicare because of a disability or end stage renal disease a six month Medigap open enrollment window.
- Florida has no birthday rule. Some states let you change Medigap plans around your birthday without health questions. Florida does not.
- Moving to or within Florida. If you are in a Medicare Advantage plan and move out of its service area, that can give you a guaranteed issue right. If you already have a Medigap policy, you can usually keep it when you move to Florida, though the premium may change.
- COBRA. According to Medicare, if you have COBRA you can buy a Medigap policy right away, or wait until COBRA ends. Either way, the 63 days count from the latest of the date coverage ends, the date on the notice, or the date on a claim denial. COBRA and Medicare have tricky timing rules, so let’s look at your dates together before you drop anything.
- Losing an ACA Marketplace plan does not by itself give you a Medigap guaranteed issue right.
Leaving a Medicare Advantage plan without a guaranteed issue right is a different story. Read the Florida rules for switching from Medicare Advantage to a Supplement before you disenroll.
Document Checklist
The insurance company will want proof that you qualify. Gather these before you apply:
- The letter from your employer, union or plan saying your coverage is ending, with the end date. Medicare’s term for this is a notice of termination.
- If your Medicare Advantage plan is leaving, the plan’s non-renewal letter.
- The postmarked envelope the letter came in. Medicare suggests keeping it as proof of the date.
- Any claim denial letter, if that is how you learned your coverage ended.
- Your red, white and blue Medicare card, showing your Part A and Part B start dates.
- A list of your doctors and prescriptions, so we can line up your Part D drug plan at the same time.
If Your Window Has Closed
Missing a guaranteed issue window is stressful, but it does not mean you are out of options.
- You can still apply for a Medigap plan with health questions. Many people with well controlled conditions are approved, and companies ask different questions.
- A Medicare Advantage plan may be an option during the Annual Enrollment Period, October 15 to December 7, without health questions. See my Medicare Advantage vs Supplement guide for Florida.
- Check whether another protected window applies to you, like Florida’s group coverage window.
- SHINE, Florida’s free State Health Insurance Program, can also help you review your options.
Working With an Independent Broker in Daytona Beach
As an independent broker, I work with multiple carriers, not one. That matters with guaranteed issue rights, because carriers handle these applications differently. Some make it easy, and some make it a paperwork nightmare.
I am licensed in 30+ states, including Florida. My home base is at 913 Big Tree Road in South Daytona, and I serve clients throughout Volusia County, Flagler County, and remotely across the country.
There is no broker fee. The insurance carrier pays my agency, so you pay the same premium you would pay calling the company directly, and you get an advocate who knows the local doctors in Ormond Beach and Port Orange.
Frequently Asked Questions About Guaranteed Issue Rights in Florida
What are Medicare Supplement guaranteed issue rights?
They are specific situations where an insurance company must sell you certain Medigap policies, cover your pre-existing conditions, and not charge you more because of your health.
Do I get guaranteed issue rights if I retire or quit my job?
If you have Medicare and your employer or union coverage that pays after Medicare is ending, generally yes. You have up to 63 days to apply, and you can choose from Plans A, B, C, D, F, G, K or L (C and F only if you were eligible for Medicare before 2020). Florida also has a 2 month window after group coverage ends.
Can I get Plan N with guaranteed issue?
In most guaranteed issue situations, no. The exception is the trial right when you joined a Medicare Advantage plan at 65 and leave within the first 12 months. Then you can buy any Medigap policy sold in Florida, including Plan N.
My Medicare Advantage plan is leaving in 2027. What can I buy?
You can buy Plan A, B, C, D, F, G, K or L without health questions (C and F only if eligible before 2020). Apply as early as 60 days before your plan ends and no later than 63 days after.
Can I be denied a Medigap plan if I have cancer but have a guaranteed issue right?
No. With a valid guaranteed issue right, the company cannot deny you an eligible plan or charge you more because of your health.
Does Florida have a birthday rule for Medigap?
No. Florida has no birthday rule, so outside your Open Enrollment or a guaranteed issue situation, a company can ask health questions.
Do you charge a fee to check if I have a guaranteed issue right?
No. There is never a broker fee. The carrier pays my agency.
Medicare Help in Daytona Beach and Beyond
Whether you are in Daytona Beach, Port Orange, Ormond Beach, or further out in Flagler or Marion County, the rules are strict, and insurance companies aren’t always eager to remind you that they have to accept you. I also work with clients remotely across Florida and in the 30+ states where I hold a license.
Ready to Check Your Rights?
Don’t let the 63 day window close on you. I can confirm whether you have a guaranteed issue right, which plans you can buy, and compare Plan G and the other eligible plans in your ZIP code.
Book a free review: schedule a time that works for you
Call or text: (386) 401-5644
We represent all of the Medicare plan organizations available in Volusia County. You can also contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHINE in Florida) to get information on all of your options.
Nathan Curry is an independent health insurance broker based in South Daytona, Florida, licensed in 30+ states. He specializes in Medicare, ACA Marketplace, and group health plans and has helped clients across Florida and nationwide navigate coverage decisions.
Contact: (386) 401-5644 | Book a free review