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When is a Medicare Supplement Insurance consumer subject to underwriting and screened for eligibility?

a Only when the consumer is in their Medicare Supplement Open Enrollment.
b When the consumer is not in their Medicare Supplement Open Enrollment or does not meet Guaranteed Issue criteria.
c Only when the consumer meets Guaranteed Issue criteria applicable in their state.
d Always to determine their acceptance.

1 Answer

4 votes

Final answer:

Medicare Supplement Insurance consumer subject to underwriting and screened for eligibility is: b When the consumer is not in their Medicare Supplement Open Enrollment or does not meet Guaranteed Issue criteria.

Step-by-step explanation:

Medicare Supplement Insurance consumers are subject to underwriting and screened for eligibility when they are not in their Medicare Supplement Open Enrollment or do not meet Guaranteed Issue criteria. During the Medicare Supplement Open Enrollment period, which typically begins when an individual is 65 or older and enrolled in Medicare Part B, they have the right to buy any Medicare Supplement plan available in their state without undergoing medical underwriting.

This period lasts for six months, and during this time, insurance companies are generally not allowed to deny coverage or charge higher premiums based on the applicant's health status.

However, outside of this Open Enrollment window, if a consumer applies for Medicare Supplement Insurance or does not meet Guaranteed Issue criteria, the insurance company may subject them to underwriting.

Underwriting involves evaluating the applicant's health history, and the insurance company may consider pre-existing conditions when determining eligibility and premium rates. This process allows insurers to assess the risk associated with covering an individual and helps determine the terms of the coverage.

It's crucial for consumers to be aware of these timelines and criteria to make informed decisions about when to enroll in Medicare Supplement Insurance, as waiting beyond the Open Enrollment period or not meeting Guaranteed Issue criteria may lead to underwriting and potential challenges in obtaining coverage.

Therefore, the correct answer is: b When the consumer is not in their Medicare Supplement Open Enrollment or does not meet Guaranteed Issue criteria.

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