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How Does Medicare View Pre-Existing Conditions?

Posted by Melissa Hanes
Estimated Reading Time 1 minute 13 seconds

How Does Medicare View Pre-Existing Conditions?

Throughout your lifetime, you’ve probably become accustomed to dealing with various health insurance issues. So you might know that pre-existing conditions sometimes complicate health insurance enrollment, and you’re wondering if the same situation can happen with Medicare. The answer is: It depends on the condition, and it depends on your Medicare plan.

Medicare plans that do not deny coverage based on pre-existing conditions…

If you want to enroll in a Medicare Advantage plan, you won’t be denied coverage due to a pre-existing condition. You can enroll or switch between Medicare Advantage plans at the same times you would normally be able to do so.

If you want to enroll in Original Medicare, pre-existing conditions won’t prevent that option. However, if you want to add a Medicare Supplement (Medigap) plan, you could be denied based upon your condition.

Medicare plans that might deny coverage based upon a pre-existing condition…

During your original Medicare enrollment window, you can enroll in Original Medicare plus a Supplement (Medigap) plan, regardless of any pre-existing conditions.

However, if you decide to elect a Medigap plan later, your health is assessed, and you could be denied based upon a medical condition. That’s why it is so important to consider the Medigap option very carefully at the time you turn 65 and enter your original enrollment window. If you turn down the opportunity to enroll in a Medigap plan, you might not be able to do so later.

Working with a licensed agent can help you to understand the differences between plans, and sort through all of the options available to you. This is especially true if you have a pre-existing condition, so don’t hesitate to give us a call if you need help comparing plans.

Melissa Hanes
OKMedicareHelp.com // getmedicarehelp@melissahanes.com

I was born in Oklahoma and raised in Neosho, MO. My husband (Derek) and I have 6 children and 6 sweet grandchildren who we adore. It wasn’t until 2009 when I moved back to Oklahoma that I started my insurance career and developed a passion for educating seniors on their rights and options regarding Medicare. Over the last decade I’ve been helping this under served population by empowering them to make the best insurance decisions for their individual healthcare needs.

In 2019 I resigned my position as Sales Manager for one of the nation’s largest Medicare insurance carriers to join the amazing team at OKMedicareHelp. I provided support, training and mentorship to hundreds of independent insurance agents around the state of Oklahoma and gave them the tools they needed to make the right impact for Medicare beneficiaries. The experience I gained in my previous role gave me a unique look at how to help navigate the complexities of Medicare for both Medicare beneficiaries and agents alike.

I pride myself on operating with the highest integrity and having a heart to serve our local senior community. I would be honored to help you navigate the complexities of Medicare and be of service for all your insurance needs.

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