Medicare beneficiaries enrolled in Medicare Advantage plans that withdraw from their counties for 2027 will gain a federal protection that many do not know they have: the right to buy any Medigap supplemental policy sold in their state, with no medical underwriting. The protection is tied to a specific application window, running 60 days before coverage ends through 63 days after, and it applies regardless of a person’s health status or pre-existing conditions. With the Contract Year 2027 Medicare Advantage and Part D Final Rule now setting the regulatory calendar for plan changes, the clock is already ticking for affected enrollees to understand their options.
How 2027 MA plan exits activate Medigap guaranteed issue rights
When a Medicare Advantage insurer pulls out of a service area or terminates a contract, the enrollees left behind do not simply lose coverage. They revert to Original Medicare and, at that point, federal law grants them what is known as a guaranteed issue right. According to the federal consumer guidance on Medigap enrollment, beneficiaries in certain qualifying circumstances can buy any standardized policy sold by an insurance company in their state. That means insurers cannot reject applicants, charge higher premiums based on health history, or impose waiting periods for pre-existing conditions during the protected window.
The application window itself is precise: it begins 60 days before the Medicare Advantage coverage ends and extends 63 days after. That timeline is not an informal administrative guideline. It is grounded in the Medigap standards codified at 42 U.S.C. 1395ss, a section of the Social Security Act that defines guaranteed issue periods when coverage is lost or changed. The statute requires that beneficiaries be given a 63-day period following notice or termination of certain coverage, including when a Medicare Advantage plan stops serving their area, giving enrollees a defined but narrow corridor to act.
The Centers for Medicare & Medicaid Services (CMS) Contract Year 2027 Medicare Advantage and Part D Final Rule establishes the regulatory calendar that will govern which plans can operate in specific counties and what changes they may make. As insurers finalize their 2027 offerings, some may decide to exit particular markets or discontinue plan contracts. Those decisions, once approved and announced under CMS timelines, are what will ultimately trigger the guaranteed issue protections for Medigap buyers whose Medicare Advantage plans are no longer available.
CMS has also worked with state regulators to clarify how these rights function in real-world scenarios. A question-and-answer document developed with the National Association of Insurance Commissioners (NAIC) and posted through the main CMS Medigap portal explains that beneficiaries affected by plan terminations must be treated as guaranteed issue applicants for eligible Medigap plans. This includes honoring the full 63-day post-termination period and refraining from medical underwriting or pre-existing condition exclusions when applications are submitted on time.
What federal sources confirm about Medigap enrollment after plan termination
Federal sources consistently describe a two-step transition when a Medicare Advantage plan terminates or withdraws from a county. First, enrollees are returned to Original Medicare Parts A and B as of the effective date of the plan’s exit. Second, they receive a temporary right to purchase Medigap coverage on a guaranteed issue basis. CMS materials stress that, outside of the initial six-month Medigap open enrollment tied to a person’s Part B effective date, most people cannot freely switch into Medigap without underwriting unless they have one of these special protections.
In the context of a plan termination, the guaranteed issue right is broad. Beneficiaries generally may choose among any standardized Medigap plans offered to new enrollees in their state, subject to state-specific variations that build on the federal floor. Insurers cannot steer applicants only into higher-cost or less comprehensive options, nor can they delay coverage with pre-existing condition waiting periods. As long as the application is submitted within the 60-day pre-termination to 63-day post-termination window, the company must accept the applicant and issue the policy at the same premium it would charge a similarly situated beneficiary without health issues.
Federal guidance also underscores that these protections are time-limited. Once the guaranteed issue window closes, applicants who did not enroll in Medigap may face medical underwriting if they later seek supplemental coverage. Insurers could then review medical records, deny coverage outright, or charge higher premiums based on health status. For that reason, CMS communications encourage beneficiaries to pay close attention to termination notices and calendar deadlines, and to begin comparing Medigap options as soon as they learn their Medicare Advantage plan will not be available for the upcoming year.
For 2027, the interaction between the final rule’s implementation schedule and Medigap protections means that beneficiaries in affected counties will likely receive plan non-renewal or termination notices in the fall preceding the coverage year. Those notices start the countdown to the guaranteed issue window. Beneficiaries who wish to avoid gaps in supplemental coverage should consider submitting Medigap applications during the pre-termination portion of the window so that their policies can take effect seamlessly when the Medicare Advantage plan ends.
Ultimately, the federal framework reflected in the Social Security Act, CMS regulations, and official consumer-facing guidance is designed to ensure that beneficiaries are not left without access to supplemental protection when a Medicare Advantage plan exits their market. For enrollees facing a 2027 plan withdrawal, understanding the existence, scope, and timing of these Medigap guaranteed issue rights will be essential to maintaining stable coverage as the Medicare landscape continues to shift.
