Preexisting conditions are health problems you had before applying for or enrolling in a new insurance plan. Some can be chronic diseases, such as diabetes, high blood pressure or cancer. Others can be mild conditions, such as seasonal allergies or acne.
Original Medicare (
Let’s see how these conditions are handled by the
Does Original Medicare cover preexisting conditions?
Yes. When you sign up for Original Medicare, any preexisting condition will be covered immediately. However, you’ll still be responsible for all out-of-pocket expenses like deductibles, copayments and coinsurance.
Does Medicare Advantage cover preexisting conditions?
Yes.
Do Medicare Supplement insurance plans cover preexisting conditions?
It depends on when you enroll and the Medicare Supplement insurance company you choose.
To get guaranteed Medigap coverage, you need to apply during your Medicare Supplement Open Enrollment Period (OEP). The Medicare Supplement OEP starts on the first day of the first month when you’re age 65 or older and enrolled in Medicare Part B. This is a 1-time window when Medigap companies can’t turn you down or charge you more for a preexisting condition.
If you miss your Medicare Supplement OEP, you miss a chance at guaranteed approval as well. Medigap companies can choose to charge you more, impose a waiting period or deny your application because of a preexisting condition.
There are certain situations where you may be able to buy a Medigap policy outside of your Medicare Supplement OEP. These are called “guaranteed issue rights” or “Medigap protections.” For more information, check out these common
Original Medicare, provided by the U.S. Government, does help cover preexisting conditions. Medicare Advantage and Medigap plans, which are offered by private companies, have their own rules. To learn about Medigap plans with Humana, check out our
Frequently asked questions
1. Is there a minimum waiting period for a preexisting condition under Medicare?
Not for everyone. In some cases, a Medigap insurance company can refuse to cover out‑of‑pocket costs for preexisting health problems for up to 6 months. This is called a “preexisting condition waiting period.” After 6 months, the Medigap policy will cover the preexisting condition.1
2. When can I switch Medicare Advantage plans with a preexisting condition?
If you’re currently enrolled in a Medicare Advantage plan, you have 2 enrollment periods per year to switch plans:
3. Can you change Medicare Supplement plans with preexisting conditions?
Yes. If you’ve had your current Medigap policy for under 6 months, you can switch to a different Medigap policy. However, you may have to wait up to 6 months before any new benefits start or your preexisting condition will be covered.2
