Medigap and Pre-Existing Conditions

One HUGE topic in the Medicare world should be, yes “should” be, about the connection between pre-existing conditions and Medicare eligibility.

Much of the population doesn’t realize that during the Medicare years, pre-existing condition issues and insurance coverage have NOT been eliminated.  Under current law (and only with the NON-Medicare population), health insurance carriers cannot deny nor charge you more for insurance due to pre-existing conditions.

Unfortunately, that thought is taken by many into the Medicare purchasing years. They often realize too late that this isn’t the case.

When a person is new to Medicare Part B coverage (and this can be at age 65, 72, 78 for example – any age), they have a six month window of opportunity (called the Medigap OPEN ENROLLMENT) to secure a Medigap contract with no health questions asked of them.  If that same person comes back 3 years later to purchase a Medigap policy after being diagnosed with cancer, they will be denied coverage (some carriers have guaranteed acceptance; meaning you will pay an additional 200-400% more in premium but WILL be accepted).

If you or someone you know is enrolling into Medicare, be sure that they have the conversation about Medigap’s “open enrollment” window.  This is a critical conversation to have.

Similarly, if you are healthy and enroll into a Medicare Advantage plan for 4 years (example).  You suffer a stroke and want to obtain Medigap coverage. You can’t.

Moral of the story? Know what you are buying at the onset and have long-range thinking involved.