Pre-existing Conditions for Medicare Supplements?
If you are turning 65 and have any pre-existing condition use caution before deciding to purchase a Medigap Plan. As of January 1, 2019, companies providing Medicare insurance can decide not to cover your pre-existing condition for as much as six months in most states (three months in Texas) on all new Medicare Supplement or Medigap plans. Not all Medicare Insurance companies will enforce the rule of pre-existing conditions, so it is very important to verify before purchasing.
Keep in mind that even if you sign up when you have guaranteed issue rights, the Medicare insurance company can make you wait up to six months before covering your pre-existing conditions. Pre-existing conditions are any health problems you had before the insurance policy started. This delay in coverage is known as the pre-existing condition, waiting period.
If you have guaranteed-issue rights, federal law forbids the insurer from denying you coverage or making you wait for your Medigap Coverage to start. However, many people are surprised to learn that there’s a waiting period before certain pre-existing conditions are covered, even if they sign up during their Medicare Initial Enrollment Period.
By law, Medicare Supplement plans can only delay coverage for any health conditions that were diagnosed or treated within six months before the Medigap policy start-date. This is known as the look-back period, the amount of time a Medigap plan can “look back” and delay coverage for certain health conditions.
During this six-month waiting period, you’ll still be covered for any Medicare-covered services you get for these pre-existing conditions, under Original Medicare, Part A and Part B. However, your Medigap plan may not cover out-of-pocket costs like copayments and coinsurance if you’re getting treatment for an excluded condition. After the pre-existing condition, waiting period is over; the Medigap plan will cover out-of-pocket costs for these health conditions.
What does this mean for you? If you’re joining a Medicare Supplement plan, and you’ve been recently diagnosed with health conditions in the past six months, find out if the Medigap plan requires a pre-existing condition, waiting period. If it does, you may want to budget accordingly for copayments and coinsurance costs, knowing the plan may not cover cost sharing for up to six months or find a Medigap plan that covers all pre-existing conditions..
Do you have questions about how Medicare Supplement plans cover pre-existing conditions? We can help you figure out your Medigap options www.franksinsurancegroup.comor call 903-868-0791.