Under California's Medigap rules (CIC Section 10192.12), guaranteed issue rights arise when a beneficiary:
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
CIC Section 10192.12 grants guaranteed issue rights — the right to purchase a Medigap policy without health-status underwriting — in defined circumstances, most notably when a beneficiary involuntarily loses Medicare Advantage coverage: the plan discontinues its product in the area, the beneficiary moves outside the plan's service area, or the plan otherwise ends coverage through no fault of the beneficiary. In those situations the insurer must sell a Medigap policy without denying or surcharging for health. Voluntary, price-driven switching does not create these rights.
Why the other options are wrong
- B) Choosing to change Medigap policies because the premium is too high is a voluntary decision and does not trigger guaranteed issue rights. Voluntary decisions do not create a statutory right.
- C) No Medigap policy covers long-term custodial care; that benefit lies outside the Medigap standardized plans entirely. Long-term custodial care lies outside every standardized Medigap plan by design, entirely without exception.
- D) A beneficiary generally cannot hold Medigap and Medicare Advantage simultaneously; the two coverage paths do not coordinate. Holding both Medigap and Medicare Advantage together is generally not permitted at once.
Memory hook
Guaranteed issue = the safety hatch when an MA plan vanishes or you move out of its area: insurers must take you, health history ignored.