How Do I Change Medicare Supplement With A Pre-Existing Condition?





A Medicare supplement, also known as a Medigap policy, is a private health insurance used in conjunction to a Medicare policy. This policy will pay many of the health care costs that are not covered by Medicare including deductibles, coinsurance and co-payments. A pre-existing condition is a health condition that existed before applying to a health insurance. Examples of pre-existing conditions are hypertension, diabetes, chronic obstruction pulmonary disease (COPD), etc.

Guidelines to Buying Medicare Supplement

When buying a Medicare supplement, there are a few guidelines to adhere to. You must have Medicare Part A and Part B. This policy will only cover you; your spouse will have to purchase their own policy. These policies do not cover prescription drug costs; you will need to purchase a separate prescription drug plan.

Buying a Medicare Supplement with a Pre-Existing Condition

The best time to purchase a Medicare supplement, when you have a pre-existing condition, is during the open enrollment period. This period lasts for 6 months, beginning the first day of the month when you are 65 and enrolled in Medicare part B. During this period, an insurance company cannot make you wait before coverage to begin or charge you a higher premium for a pre-existing condition. If you are changing your Medicare supplement policy and have six months of continuous coverage, you cannot be held to the pre-existing coverage waiting period. You also have “guaranteed issue rights” in which the insurance company is required by law to offer a policy, cannot charge a higher premium and must cover any pre-existing conditions.

What are Guaranteed Issue Rights?

Guaranteed issue rights occur when several factors exist, allowing you to change your Medicare supplement despite having a pre-existing condition.

• Your current policy is leaving Medicare, suspends coverage in your area or you move.
• Your employer group health plan is ending.
• You decide to switch within the first year of joining a Medicare Advantage plan.
• Your Medicare supplement plan goes bankrupt and you lose coverage.
• You decide to switch plans because your Medicare supplement plan mislead you or hasn’t followed the rules.



6 Responses to “How Do I Change Medicare Supplement With A Pre-Existing Condition?”

  1. Deidre McNamara says:

    My husband will be 65 in December, retired early because of a disabilty. I work and want to carry him on my policy next year after which I plan to retire. An insurance agent told us that because of his pre-existing condition that he would not be able to qualify for supplemental insurance without qualifying medically. He said it was a new law and he would e-mail me the interoffice information but that I needed to keep it confidential.The social security office said that if my husband notified them within 3 months that he could not be turned down. Can you help clear up what the facts are?
    Thanks
    Deidre McNamara

  2. Stan Coffee says:

    As long as your husband signs up for his medicare supplement policy during his guaranteed issue period, he cannot be turned down. Contact me at 210-538-9872 ands I can help you with your questions.

  3. Dorothy says:

    If my husband switches from a full coverage medicare supplent to a deductible plan with the same company, does he have to qualify medically?

  4. Dianna Bryant says:

    My mother is 89 years old and has had Medicare and her health insurance through a previous employer since she was 62. That plan through United Healthcare has notified that she only has $13,000. of coverage remaining so she now needs a Medicare supplement. She was recently admitted to the hospital 10/1/2012 and discharged to a skilled nursing home 10/4/2012. She also has a new diagnosis of Dementia. Can she get a supplement and should this be done during open enrollment even if she has not used all of the $13,000 with United Healthcare? thank you.

  5. sandra says:

    I’m 51 have had medicare A and B since 1986 due to illness. If I get a medicare supplement insurance will the supplement insurance cover my pre-exsiting condition? Can I be turned down for a supplement?

  6. Bill Riley says:

    I have a Blue Cross/Blue Shield plan J which I have had for more than 5 years. I was told by one of their agents that I should change to plan f which was just like the j plan and it would be cheaper. They sent me the application for the f plan which I filled out with their help also stating that I had prostate cancer in 2010 but am now in remission. I just received a reply from them denying me coverage on the plan f due to my prostate cancer. I thought that you could not be turned down with a pre existing condition if you were just changing from one plan to another. So now I am stuck in a J plan which cost me more money. Should I continue to try to get in the F plan or just stay where I am at with the J plan.

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