During the Medigap open enrollment period, insurers:
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Answer & full 3-part explanation (select an option above, or peek)
Why D is correct
The Medigap open enrollment period begins when a beneficiary is 65 or older and enrolled in Medicare Part B. During this window, insurers must sell a Medigap policy without medical underwriting; they cannot deny coverage or charge more because of health conditions. This guaranteed issue protection is the main reason enrollment timing matters: waiting beyond open enrollment can mean underwriting and denial. The rule protects consumers at the point when they most need supplement coverage. The six-month open enrollment window is the one period when federal law forces a guaranteed-issue market: every Medigap policy must be sold to the applicant regardless of health status. After the window closes, the same applicant faces medical underwriting and can be declined or surcharged, which is why the window is so valuable.
Why the other options are wrong
- A) Denying coverage for health reasons during open enrollment would violate the guaranteed issue requirement. Denial based on health is prohibited during the six-month open enrollment window because medical underwriting is suspended for that period.
- B) Premiums during open enrollment are not risk-rated by the individual's health. Premium surcharges for preexisting conditions are barred during open enrollment; guaranteed issue applies regardless of health status. The premium cannot vary by health status during this window.
- C) Open enrollment is not limited to replacement policies; it applies to initial Medigap purchases at 65. There is no replacement-only rule; the open enrollment right applies to any new Medigap purchase during the window.
Memory hook
Open enrollment = Medigap's no-questions-asked window: no underwriting, no denial.