What Is the Waiting Period to File a Claim With Medigap Insurance in Georgia?

Like most private health insurance plans, Medicare requires subscribers to contribute copayments for medical services. Subscribers who want to minimize their liability can purchase Medigap plans, also known as Medicare supplements. The Centers for Medicare and Medicaid Services (CMS) authorize insurers to issue plans specific to Medicare subscribers' needs but leaves it to each state to regulate and oversee participating insurance companies. In Georgia, insurers cannot delay coverage in a Medigap policy except for certain pre-existing conditions.

Coverage

• Georgia mandates that insurers provide immediate coverage upon enrollment. Patients do not have to wait to begin making claims for covered illnesses and conditions. Policyholders who have difficulty with their insurers or believe their insurers are undertaking unfair practices can report issues to the Georgia Department of Insurance.

Pre-existing Conditions

• Medigap insurers are afforded one exception to the rule of immediate coverage -- they can exempt pre-existing conditions for six months. Subscribers who have had major medical issues such as surgeries and chronic illnesses such as cancer may legally be denied their claims for the first half-year of their policies. However, smaller scale recent issues such as recurring pneumonia or influenza are not among the conditions that Georgia qualifies as pre-existing.

Careful Shopping

• Georgia residents have many choices for Medigap insurance. Before selecting a policy, potential subscribers should examine their full array of options and consult the Office of Insurance and Safety Fire Commissioner about any complaints or investigations of Medigap insurers. Additionally, the Better Business Bureau keeps records of consumer complaints and can advise those shopping for plans of any hassles experienced by policyholders.

Guidance

• Medicare subscribers can get a complete list of Medigap insurers as well as information about Medicare supplements from CMS. Information is available at Medicare.gov and by requesting handbooks and booklets by calling the Medicare customer service line. Further, Medicare subscribers who elect Part C coverage through a Medicare Advantage plan usually do not need Medigap insurance. Medicare participants should understand their insurance coverage and options before buying supplemental plans.