Skip to content
Speak with a licensed insurance agent
Mon – Fri: 9am – 8pm ET
Ensurem
A 777 Partners Portfolio Company

What to Know About Pre-Existing Conditions and Medicare Supplements

Read more about Medicare supplements with pre-existing conditions: http://bit.ly/2Oa8NQk
Learn more about Medicare and Medicare supplements at Ensurem.com: http://bit.ly/2OaYxXQ
Be sure to follow us on Facebook: http://bit.ly/2XBUzus!

What Are My Medicare Supplement (Medigap) Rights with a Pre-Existing Condition?
One of the biggest worries people have about switching to Medicare is receiving coverage while having a current health problem or pre-existing condition. Many are concerned about whether they will be able to purchase Medicare Supplement insurance – often referred to as Medigap – or whether they will be denied coverage or left with extremely expensive premiums because of a pre-existing condition. The good news is you have options and rights.

Transcript:
If you have pre-existing conditions, you may worry about whether Medicare Supplement plans will cover bills related to your illness.
WHAT ARE PRE-EXISTING CONDITIONS?
A pre-existing condition is a condition with which you were diagnosed prior to applying for a health insurance policy. For instance, if you have had Type 1 Diabetes your entire life, you have a pre-existing condition. Similarly, if you were diagnosed with Type 2 diabetes three years ago, you also have a pre-existing condition.
Insurance companies view people with pre-existing conditions as an increased risk.
Pre-existing conditions don’t include short-lived diseases from which beneficiaries recover. For instance, if you’ve ever been diagnosed with strep throat, the insurance company wouldn’t consider it a pre-existing condition.
APPLY DURING YOUR IEP FOR MEDICARE SUPPLEMENTAL INSURANCE
The Initial Enrollment Period (IEP) starts the first day of the month in which you turn age 65. During your IEP, you can apply for any Medigap insurance plan you want without worrying about your pre-existing conditions. Insurance companies that offer your desired plan in your zip code can’t increase your premium or deny your coverage based on conditions you might already have.
If you apply for Medicare Supplemental insurance outside your IEP, such as seven months after you turn 65, you become subject to underwriting. To avoid paying high premiums of eliminating your right to Medicare Supplement plans, mark your IEP dates in your calendar.
IEP vs. OEP
The IEP is different from Original Medicare’s Open Enrollment Period, which occurs once per year from October 15 to December 7. The OEP applies primarily to beneficiaries of Medicare Part C, which is also called Medicare Advantage (MA). If you have a Medicare supplemental insurance plan, you won’t be able to switch without becoming subject to underwriting.
Insurance companies use underwriting to determine a beneficiary’s risk and to adjust premium prices accordingly. Should underwriting apply, the insurance company can increase your Medigap insurance premium considerably or deny you coverage altogether.
UNDERSTAND THAT A SIX-MONTH WAITING PERIOD MIGHT APPLY FOR MEDIGAP INSURANCE
Some insurance companies institute a six-month waiting period for new beneficiaries of Medicare Supplement plans. During this time, your plan won’t cover costs related to your pre-existing condition. However, once the waiting period elapses, the insurance will begin to pick up those costs.
The pre-existing condition waiting period doesn’t apply to Original Medicare. You’ll still receive coverage for your condition, but you’ll be responsible for co-payments, co-insurance, and deductibles.
In some cases, the waiting period won’t apply at all. If you have continuous creditable coverage from a different health insurance company during the six months prior to applying for your Medigap insurance, your coverage will begin immediately. Similarly, if you have creditable coverage for a shorter time frame, you can reduce your waiting period by that amount.
CONCLUSION
Pre-existing conditions can prove difficult to navigate when it comes to health insurance. Fortunately, Medicare preserves your rights when you apply for Medicare supplemental insurance during your IEP or when you have guaranteed issue rights.

Enroll Your Way

Shop and enroll on your own time with Emma

Have our virtual assistant, Emma, guide you through the Medicare plan selection and enrollment process.

OR

Shop and enroll over the phone with an agent

Speak with one of our licensed insurance agents who can guide you through the Medicare plan selection and enrollment process.

HIPAA EnsuremVERIED & SECURED EnsuremSSL SECURED Ensurem