Original Medicare will accept folks with pre-existing conditions. In fact, Medicare will cover all pre-existing conditions and they don’t ask any health questions or have any limitations. However, with Original Medicare, it’s important to note that Parts A and B will only cover up to 80% of your Medicare or healthcare expenses. This means that 20% of costs will have to come out of pocket.
In order to mitigate that problem, private insurance companies have come up with Medicare supplement plans and Medicare Advantage plans that can reduce cost or fully cover additional medical costs.
To learn more about Medicare or if you have any Medicare supplement questions, contact us at 800-208-4974. One of our trusted insurance agents will be able to answer any questions you may have and provide a free consultation.
What does Medicare cover?
When you turn 65 you are eligible to sign up for Medicare Parts A & B. In addition folks under the age of 65 can qualify with certain disabilities. Part A will cover all your inpatient needs, hospitalizations, and any medical treatments needed for your pre-existing condition will be covered.
Original Medicare Part B will cover your outpatient needs, such as doctor visits, ambulance services, durable medical equipment, mental health plan, hospice care, lab work, preventative care, and more.
However, as mentioned before, there are still some things that Original Medicare won’t cover which is dental care, eye exams, long-term care, denture, hearing aids, and more. That’s when having a Medicare supplement plan or Medicare Advantage plan can really help.
Do Medicare Supplement Plans Accept Pre-existing Conditions?
Medicare Supplement plans may or may not cover pre-existing conditions. In most cases, if you are applying outside of your “Open Enrollment” window you will be required to pass “health underwriting.” This is when the insurance carrier asks you a series of health questions. With most carriers, if you are accepted then you will be covered 100% right away. There are a handful of companies that may impose a “waiting period” for pre-existing conditions if you didn’t have any “credible coverage” within 63 days of applying for coverage.
Agent Tip
If you apply for a Medicare Supplement plan outside of your initial Open Enrollment window you can be subject to health underwriting and pre-existing condition waiting periods.
Your “Open Enrollment” period for a Medicare Supplement plans starts the first of the month your turn 65 or start Part B and lasts for 6 months. Also, in some states, you can change Medicare Supplement plans at certain times of the year such as around your birthday in California, without any health underwriting.
It will depend on the situation, however, Medicare can’t pay for products or services that workers compensation pays for. Instead, they can make a conditional payment if the worker’s insurer denies payments of medical bills. Medicare will also investigate the claim and compensation may or may not be given after 4 months or even longer.
The best time to apply for a Medicare supplement plan is during the Open Enrollment Period, this period starts the first of the month you turn 65 or start Part B and lasts for 6 months.
Do Medicare Advantage Plans Cover Pre-existing Conditions?
Medicare Advantage Plans or “Part C” covers pre-existing conditions just like Original Medicare does. No health questions are asked when signing up for a Medicare Advantage plan. Also, Medicare Advantage or Part C plans usually include Part D, prescription coverage. In addition, you may get additional benefits such as dental, vision, and hearing coverage.
To learn more about Medicare Advantage plans, Prescription drugs, or Medicare supplement plans, give us a call at 800-208-4974.
Summary
Overall, Original Medicare and Medicare Advantage plans cover pre-exsiting condition and no health questions are asked when applying for coverage. On the other hand, Medicare Supplement plans (Medigap) may ask health questions if you are outside of your Open Enrollment window.
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If you have any Medicare-related or health care coverage questions or would like to know more about your Medicare supplement options, contact us at 800-208-4974.
