Pre-Existing Conditions and Medicare

Pre-existing conditions are a popular insurance concern. Most American have been diagnosed with a pre-existing condition by the time they reach Medicare age — it’s a byproduct of living through six-plus decades of wear and tear on our bodies. It’s only natural to be worried that you have pre-existing conditions that might cause problems with your Medicare choices. That’s why we’re going to look at what different Medicare options do about pre-existing conditions and how you can get the most out of your coverage.

What Is a Pre-Existing Condition?

A pre-existing condition is any health problem that you had prior to your enrollment in Medicare. Under federal law, Medicare cannot refuse coverage based solely on pre-existing conditions. If this were not the case, thousands of seniors would have coverage issues every year. What this means is that you cannot be denied coverage based on your pre-existing conditions. Certain Medicare Supplement plans may have some restrictions, but we’ll go into more detail on that later.

Does Medicare Part A Cover Pre-Existing Conditions?

Medicare Part A covers pre-existing conditions. Medicare Part A is considered the minimum acceptable coverage for Medicare beneficiaries. That means that, for those who qualify for Medicare, this is the minimum coverage you can have. There are no limitations on coverage based on pre-existing conditions, and Part A inpatient care will pay for covered hospital services needed regardless of condition.

Does Medicare Part B Cover Pre-Existing Conditions?

Medicare Part B likewise covers pre-existing conditions. You are legally entitled to Original Medicare coverage regardless of medical history. This means that you will be able to receive both parts of Original Medicare when you become eligible for enrollment.

Do Medicare Advantage Plans Cover Pre-Existing Conditions?

Medicare Advantage plans are offered by private insurance companies. However, they are held to the same standards as Original Medicare. They must offer the same basic coverage as Original Medicare, but many offer additional coverage for prescriptions and other specialized care. Legally, Medicare Advantage plans cannot charge more money to those with pre-existing conditions.

Do Medicare Part D Drug Plans Cover Pre-Existing Conditions?

Medicare Part D Drug Plans provide prescription coverage regardless of pre-existing conditions. Logically, if you are taking a prescription, it’s for a medical condition. Due to that fact alone, Part D is in the business of covering conditions both previously diagnosed and recently diagnosed.

Do Medicare Supplement Plans Cover Pre-Existing Conditions?

Medicare Supplement plans are supplemental coverage for Original Medicare Parts A and B.

People who enroll in a Medicare Supplement cannot be asked any medical/health questions if you enroll during your Initial Election Period, which is a six-month time frame around your 65th birthday. However, if you don’t enroll during this time or wish to switch Medicare Supplement plans later, you will likely be subject to medical underwriting, which looks at medical and health history, and acceptance criteria can vary by plan.

Conclusion

No matter what condition you have, you will be able to find a Medicare option that works for you. Finding a plan that’s right for you is the most important thing. That’s where PlanEnroll can help! Our licensed insurance agents are here to help you find coverage that fits your needs and your budget.

PlanEnroll is a brand operated by Integrity Marketing Group, LLC and used by its affiliated licensed insurance agencies that are certified to sell Medicare products. PlanEnroll is not endorsed by the Center for Medicare & Medicaid Services (CMS), the Department of Health and Human Services (DHHS), or any other government agency.