---
title: "Medicare Supplement Underwriting: Tips for Getting Clients Approved"
description: "Medigap underwriting is the biggest barrier to sales. Learn which conditions get declined, how to find guaranteed issue opportunities, and pre-qualification strategies."
url: https://unlockedcrm.ai/blog/medicare-supplement-underwriting-tips
canonical: https://unlockedcrm.ai/blog/medicare-supplement-underwriting-tips
category: "Medicare"
published: 2027-01-16
author: "Jacob Lock"
source: unLocked CRM — AI CRM for insurance agents
---

# Medicare Supplement Underwriting: Tips for Getting Clients Approved

## TL;DR

Medigap underwriting is required outside guaranteed issue periods. Common declines: COPD with oxygen, insulin diabetes with complications, recent cancer/heart attack/stroke. Pre-qualify clients before submitting. Try multiple carriers — guidelines vary significantly.

## Key data points

- Agents who master Medigap underwriting close 40% more supplement policies
- Controlled Type 2 diabetes, hypertension, and sleep apnea usually pass Medigap underwriting
- Each Medigap carrier has different underwriting criteria — always try multiple carriers

Medicare Supplement (Medigap) is the only Medicare product with medical underwriting outside of guaranteed issue periods. Agents who master underwriting knowledge close 40% more Medigap policies.

## When Underwriting Applies

**Guaranteed Issue (No Underwriting):**
- Medigap Open Enrollment Period (first 6 months after Part B starts at age 65+)
- Loss of employer coverage
- Medicare Advantage plan leaves the area
- Certain trial rights (trying MA for the first time)

**Underwritten (Health Questions Required):**
- Any application outside guaranteed issue periods
- Under-65 disabled Medicare beneficiaries (in most states)
- Plan upgrades (Plan G to Plan F, for example — though F is closed to new Medicare beneficiaries)

## Common Declinable Conditions

Most carriers will decline or rate-up for:
- COPD/emphysema requiring oxygen
- Insulin-dependent diabetes with complications
- Cancer treatment within 2–5 years (varies by carrier)
- Heart attack or stroke within 2–3 years
- Kidney dialysis
- ALS, MS, Parkinson's (most carriers)
- Organ transplant within 5 years

## Conditions That Usually Pass

Surprisingly, many conditions agents assume are declinable actually pass:
- Controlled Type 2 diabetes (no insulin, A1C under 8)
- Controlled high blood pressure
- History of cancer 5+ years ago with no recurrence
- Joint replacement (6+ months post-surgery)
- Controlled thyroid conditions
- Sleep apnea with CPAP
- Controlled depression/anxiety

## Pre-Qualification Strategies

1. **Ask the right questions upfront**: Use a pre-qualification questionnaire before submitting
2. **Know carrier-specific guidelines**: Each carrier has different underwriting criteria
3. **Try multiple carriers**: If one declines, another may approve
4. **Use preliminary applications**: Some carriers offer pre-screening without a formal decline on record
5. **Check guaranteed issue eligibility**: Many clients qualify and don't know it
6. **Consider alternative products**: If Medigap fails, Medicare Advantage has no underwriting

## The Pre-Qualification Questionnaire

Ask these before submitting any Medigap application:
- Any cancer diagnosis or treatment in the past 5 years?
- Currently using oxygen or on dialysis?
- Any heart attack, stroke, or TIA in the past 3 years?
- Currently taking insulin?
- Any neurological conditions (MS, ALS, Parkinson's)?
- Any upcoming surgeries scheduled?
- Currently in a hospital, nursing facility, or hospice?

unLocked CRM includes pre-qualification workflows that match client health profiles to carrier underwriting guidelines, identifying the best carriers to submit to and flagging guaranteed issue opportunities automatically.

## FAQ

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## Related

- https://unlockedcrm.ai/blog/medicare-supplement-vs-advantage
- https://unlockedcrm.ai/blog/ai-underwriting-tools-insurance

---

Source: [Medicare Supplement Underwriting: Tips for Getting Clients Approved](https://unlockedcrm.ai/blog/medicare-supplement-underwriting-tips) — unLocked CRM, the AI CRM built for insurance agents. Citation permitted with attribution and a link to https://unlockedcrm.ai/blog/medicare-supplement-underwriting-tips.