He’s 5’10” and 287 Pounds, With No Diagnosis and No Prescriptions. The Medigap Underwriter’s Height-and-Weight Chart Said No

Picture a hypothetical 68-year-old in Ohio who decides that he is done with the prior authorization headaches of his Medicare Advantage plan. He wants Original Medicare with a Medigap Plan G. He has no diagnosed condition, no prescriptions and no recent hospitalizations. He stands 5 feet 10 inches and weighs 287 pounds when he completes the application. Under one carrier’s published physique chart, those two numbers put him in the decline column before a diagnosis or medication ever enters the picture.

If you are inside your one-time six-month Medigap Open Enrollment window, or you qualify for a federal guaranteed-issue right, relax. Insurers cannot use your build against you during those windows. Everyone else applying for a supplement outside those protections is walking into medical underwriting, and the height-and-weight grid is the piece of it almost no one sees coming.

Build Chart Mechanics

Most Medigap carriers publish an underwriting guide with a height-and-weight table. The table converts your build into an underwriting class: preferred, standard, a rated (higher-premium) tier, or a decline. It is a separate gate from the health questions, and passing the health questions does not get you through it.

One previous LifeShield National underwriting guide provides a reasonable example. The guide, revised in 2024, lists 105 to 285 pounds as the standard range for a 5-foot-10 applicant and places 286 pounds or more in the decline column. Under that published chart, our hypothetical 287-pound applicant would be ineligible.

When the Chart Cannot Touch You

Federal law suspends underwriting in two places. First is the one-time six-month Medigap Open Enrollment Period that begins the month you are 65 or older and enrolled in Part B. Second is a narrow set of federal guaranteed-issue rights, including certain Medicare Advantage plan terminations, an employer plan ending, and the twelve-month Medicare Advantage trial right for first-time enrollees.

The fall Annual Enrollment Period is the trap. It lets you drop Medicare Advantage cleanly. It does not, by itself, guarantee you a Medigap policy on the way out. A 5’10”, 287-pound applicant who cancels his Advantage plan in December expecting to land in Plan G in January can end up with Original Medicare and no supplement, exposed to unlimited Part A and Part B cost-sharing on top of the $202.90 standard 2026 Part B premium. That premium is only the sticker price, and we cataloged the IRMAA surcharges and coverage gaps that ambush retirees in a free Medicare guide here.

State Rules Can Reopen the Door

As of 2026, over a dozen states give existing Medigap policyholders a birthday-linked window to switch without fresh underwriting: California, Delaware, Idaho, Illinois, Indiana, Kentucky, Louisiana, Maryland, Nevada, Oklahoma, Oregon, Utah, Virginia, West Virginia and Wyoming. Missouri offers a similar window tied to the policy anniversary, while Connecticut, Maine, Massachusetts and New York provide wider continuous or annual guaranteed-issue protections. These rules differ sharply and generally do not help someone like the hypothetical Ohio applicant, who is leaving Medicare Advantage without already owning a Medigap policy.

Two Actions Before You Cancel Anything

• First, pull two or three current carrier underwriting guides through a broker before you file a formal application, and compare their build charts row by row for your height. A weight that triggers a decline at one carrier can sit inside the standard band at another. Rate class differences of one tier could translate to 20% to 40% higher premiums for the life of the policy, so the choice of carrier is worth more than the choice of plan letter.
• Second, do not cancel a Medicare Advantage plan or an in-force Medigap policy until the new supplement has been approved in writing. The moment you drop the coverage you have, the only path back may run through the underwriting you were trying to avoid.

Our hypothetical applicant had no diagnosis to reject. The underwriter did not need one. Two numbers on the application had already answered the question.

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