Getting Health Insurance with a Pre-Existing Condition

If you have a pre-existing condition, Original Medicare will still cover your health care costs. This is Medicare Part A for hospital coverage, and Medicare Part B for doctor visits and other outpatient care.

To get additional coverage for health care costs not paid by Original Medicare, you can apply for coverage through private insurers, including Medicare Advantage or Medigap plans.

If you apply for Medicare Supplement plans during your initial enrollment period, you are guaranteed the lowest rate for coverage.

Medicare Supplement and Pre-Existing Conditions

Medigap plans cover certain health care expenses not covered by Medicare. These are expenses can include copayments, coinsurance, or your deductible.

With a pre-existing condition, you are guaranteed acceptance and are locked in to the lowest rate for Medicare Supplement plans if you enroll during your initial Medicare Open Enrollment Period when you are turning 65, or the Special Enrollment Period that occurs if you lose your employer-sponsored coverage after age 65.

By law, Medicare Supplement plans cannot deny you coverage because of a pre-existing condition if you enroll during the eligibility periods. You may still be subject to a waiting period of six months before Medigap will begin covering expenses related to your pre-existing condition. After this six-month waiting period, your Medigap plan will begin covering your health care costs related to the pre-existing condition.

To ensure that you enroll at the right time to get the best coverage for your pre-existing condition, learn more about the enrollment periods during which you should apply for coverage.