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Can I Have a Medicare Supplement Plan with Pre-Existing Conditions?

You may be uneasy about applying for a Medicare Supplement plan if you have a pre-existing condition. However, enrolling in a Medicare Supplement plan during your Medicare Supplement Open Enrollment Period mitigates the risk of being declined for coverage.

Are you looking for a Medicare Supplement plan? If so, it’s important to understand how your conditions may affect your ability to get coverage.

What are Pre-Existing Conditions?

Pre-existing conditions are any condition that you had prior to receiving your health coverage. These conditions could include a variety of illnesses or injuries, including asthma, cancer, heart disease, arthritis, and more.

Pre-existing conditions are very common. In fact, according to the Centers for Medicare & Medicaid Services (CMS), up to 86% of people between ages 55 to 64 have some type of pre-existing condition.

When Is the Best Time to Purchase a Medicare Supplement Plan If I Have Pre-Existing Conditions?

Do you have any pre-existing conditions? If so, your Medicare Supplement Open Enrollment Period would be the best time to purchase a Medicare Supplement plan. You can qualify for Open Enrollment during the first six months in which you’re enrolled in Medicare Part B, and are over 65. You can, however, submit your application up to three months before the start of your Open Enrollment Period.

Your pre-existing conditions will be covered starting on the policy effective date if you qualify for Open Enrollment. This is also true if you qualify for Guaranteed Issue, which is a circumstance in which you are guaranteed issue of a plan. Finally, your conditions will be covered on the effective date if you’re replacing a Medicare Supplement plan or other creditable coverage.

If you don’t fall in any of these categories, that’s okay. However, you would have to wait six months after the plan’s effective date before your pre-existing condition would be covered.

Can I Get a Medicare Supplement Plan If I Have Pre-Existing Conditions and My Medicare Supplement Open Enrollment Period Has Already Passed?

If your Medicare Supplement Open Enrollment Period has already passed, then you may need to go through medical underwriting. This process would allow potential approval for your Medicare Supplement plan. Unfortunately, this also means that a carrier could turn down your application because of a pre-existing condition you may have.

The various carriers that offer Medicare Supplement plans have different and specific underwriting guidelines regarding pre-existing conditions. This means that if one carrier declines your application due to pre-existing conditions, don’t panic! There’s still a chance another carrier may approve your application, despite your conditions.

What Is the Pre-Existing Condition Waiting Period?

If you purchase your Medicare Supplement plan during your Medicare Supplement Open Enrollment Period, you generally will not have to wait for your plan to begin providing coverage for pre-existing conditions. However, if you had a gap in health coverage prior to purchasing your plan, you may have a “pre-existing condition waiting period.” This means you would pay out-of-pocket for costs related to your pre-existing condition for up to six months. After the waiting period ends, your Medicare Supplement plan would then begin to provide coverage.

If you have had at least 6 months of creditable coverage prior to applying for a Medicare Supplement, you may be able to avoid the pre-existing condition waiting period.

Work with a Medicare Advisor

Pre-existing conditions won’t necessarily negate your Medicare eligibility when it comes to Medicare Supplement plans, but it can be a trickier process for those who are unfamiliar. But don’t worry – we’re here to guide you along the way.

Nothing on this website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.

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