What Is Medical Underwriting And What Does It Have to Do With Medicare?

This article isn’t meant to scare you because choosing a Medicare plan is confusing enough. However, there is one magical time period when you can get Medigap insurance without medical underwriting. So what is medical underwriting anyway?

What is Medical Underwriting?

Medical underwriting is the process that an insurance company takes to determine the risk of taking you on as an insured. Often medical underwriting is part of the life insurance policy process as well. Often during medical underwriting, you will be asked questions regarding your diet and exercise habits, how much you drink and/or smoke, as well as ask about family history. Some insurance companies also draw blood for lab work and perform a basic medical exam that includes height and weight.

Depending upon the insurance policy you’re looking for (health, term life, whole life) you may be charged higher premiums or even be denied altogether.

“Medical underwriting is the process of evaluating an application for health insurance coverage by examining the applicant's medical history. The price of coverage is determined by the risk factors of the applicant.” Investopedia

What Does Medical Underwriting Have to Do with Medicare?

Depending upon the insurance policy you’re looking for (health, term life, whole life) you may be charged higher premiums or even be denied altogether. This is why it’s vital that if you want Medigap insurance, to enroll in it right away. The magical period of time where medical underwriting is not required  “automatically starts the first month you have  Medicare Part B (Medical Insurance) and you're 65 or older. It can't be changed or repeated,” according to Medicare.

“If you apply for Medigap coverage after your open enrollment period, there's no guarantee that an insurance company will sell you a Medigap policy if you don’t meet the medical underwriting requirements unless you're eligible due to one of the situations below.” Medicare.gov

What is Medigap Insurance?

Let’s start with what Medigap insurance isn’t – it’s not a Medicare Advantage Plan. It’s literally an insurance plan to cover the gap in expenses from Parts A & B (Original Medicare). 

Think of Medigap insurance like this. You know when you buy a new car and the finance department urges you to pay for gap insurance? That’s so that if your new car gets totaled, the gap insurance covers the difference between the loan and the value of the vehicle that was totaled. This is so you don’t default on our loan. 

Part B of Medicare only covers 80% of your expenses, as Boomer Benefits notes. That remaining 20% can add up – quickly!

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