Patient Services,

Patient Resources,Social Work Services Quick Guide,Social Work Manual,Population Specific,Transplant,Kidney Transplant,Financial

ESRD Medicare and Medigap Policies

ESRD Medicare and Medigap Policies - Patient Resources, Social Work Services Quick Guide, Social Work Manual, Population Specific, Transplant, Kidney Transplant, Financial



Medigap Policies for People Under Age 65 With a Disability or End-Stage Renal Disease

Question: If I have Medicare and I want to enroll in mine or my spouse's employer group health plan, can I stop my Medigap policy?

Answer: The Ticket to Work and Work Incentive Improvement Act of 1999 gives you the right to suspend a Medigap policy. If you are under 65, have Medicare, and have a Medigap policy, you have the right to suspend your Medigap policy. This lets you suspend your Medigap policy benefits and premiums, without penalty, while you are enrolled in your or your spouse's employer group health plan.

If, for any reason, you lose your employer group health plan coverage, you can get your Medigap policy back. You must notify your Medigap insurance company that you want your Medigap policy back within 90 days of losing your employer group health plan coverage.

Your Medigap benefits and premiums will start again on the day your employer group health plan coverage stopped. The Medigap policy must have the same benefits and premiums it would have had if you had never suspended your coverage. Your Medigap insurance company can't refuse to cover care for any pre-existing conditions you have. So, if you are disabled and working, you can enjoy the benefits of your employer's insurance without giving up your Medigap policy.