Will A Pre-Existing Condition Affect Medicare Eligibility?





Waiting Period for Pre-existing Conditions

A Medigap insurance company can refuse coverage for up to six months due to a pre-existing condition. This period can only be used if the patient had a condition which was diagnosed and treated in the six months previous to the application for coverage. If you are refused for the six month period, you can register for Creditable Coverage which can cover you until you qualify for Medigap insurance.

Appropriate Coverage

It is critically important to select the correct insurance to cover any potential situations may arise. The best option, if you can afford it, is to enroll in a Medicare Supplement plan. Medicare Part A covers hospitalization while Part B covers doctors, outpatient treatments, and medical insurance. These supplements must be purchased within 6 months of registering for Medicare or your medicare eligibility will be affected because of your pre-existing condition.

Medigap Policy

Medigap is private insurance which is regulated by the Federal Government. There are about a dozen types of policies to select from. Again, pre-existing conditions will not be taken into consideration if the application for insurance is received within 6 months of registration in Medicare Part B.

Medicare Part C

Another choice is Medicare Part C Medical Insurance instead of Medigap. Medicare Part C calls for a patient to leave Medicare Parts A and B, however it offers all those items covered and more. The primary disadvantage is there may be less doctors in the Medicare Part C pool, however, it is less expensive which can be helpful for those who have pre-existing conditions and concern about medicare eligibility. Also of note is that Parts A & B do not cover most prescription drugs, so it is recommended to register for either Part D Drug benefit or Part C which includes prescription drug coverage.



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