Pre-existing Conditions

This FAQ (Frequently Asked Questions) answers common questions about Medicare and how it works with pre-existing conditions.

Pre-existing Conditions

What is a ‘Pre-existing condition'?

A pre-existing condition is a condition with which you were diagnosed or were treated for before your new health care insurance plan’s coverage commences.

What impact does this have on my Medicare coverage?

Medicare Part A and Part B and Medicare Advantage plans (Part C) cover pre-existing conditions. There are exceptions for ESRD (End-Stage Renal Disease).

Medicare Supplement plans may also cover pre-existing conditions if you apply during a ‘guaranteed issue’ period. Outside of these guaranteed issue periods, Medicare Supplement plans can decline coverage, charge a higher premium and/or impose a six-month waiting period based on the pre-existing condition(s). Rules may vary by State.

What difference does this make to my enrollment periods?

Enrollment Periods do not change for you if you have a pre-existing condition. For Medicare Supplement, see above.

Is there any impact on my share of Medicare costs?

If you enroll in a Medicare Supplement plan outside of the guaranteed-issue periods, the carrier may charge a higher premium, decline coverage or impose a six-month waiting period for payment of claims, based on the pre-existing condition(s). Rules may vary by State.

                                                                                                                                                  

Click here to learn more about Medicare, its various Parts, different enrollment periods and your costs. 

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Remember that you cannot choose just any combination of Parts and Plans. Let Lighted Road Insurance guide you step-by-step through the Medicare ecosystem and help you in selecting the right plan(s) for your needs.