Quick Answer
Medicare isn’t dependent on the status of your health. Meaning pre-existing health conditions won’t impact eligibility as long as you apply at the right time.
Coverage Comparison by Plan Type
| Plan Type | Coverage | Notes |
|---|---|---|
| Original Medicare | Covered | Covered when medically necessary |
| Medicare Advantage | Some Plans | Coverage varies by plan and ZIP code |
| Medigap | Not Covered | Only supplements Original Medicare benefits |
| Medicare Part D | May Cover Related Rx | May cover related prescriptions |
Understanding Your Coverage Options
Original Medicare (Part a & B)
Every beneficiary gets an enrollment window called your Initial Enrollment Period. At this time, you can enroll in Medicare without any health questions. Once you enroll in Part B, you’ll have another enrollment window that allows you to enroll in a supplemental plan without pre-existing conditions impacting your chances of being accepted into the plan.
Medicare Advantage (Part C)
Yes, Medicare Advantage plans will cover pre-existing conditions. This is one of the features that attract beneficiaries to Advantage plans. However, they don’t consider all the out-of-pocket costs you have to pay when you go to the doctor. Those with a chronic condition will get better long-term benefits with a Medicare Supplement (Medigap) Plan.
Medicare Supplement (Medigap)
Yes, Medicare Supplements cover pre-existing conditions as long as you enroll at the right time. When purchasing a Medicare Supplement plan during your Medigap Open Enrollment Period, you’re automatically eligible for coverage.
During this period, you’re granted Guaranteed Issue Rights. Private insurance companies offering Medigap plans cannot deny you coverage or increase your rates due to any pre-existing health conditions.
If you don’t enroll during your Open Enrollment Period, you can be denied coverage or charges a higher premium due to pre-existing health conditions.
✦ Frequently Asked Questions
David Haass
AuthorDavid Haass is a licensed Medicare expert who has been helping beneficiaries navigate their Medicare options for over a decade.
Ashlee Zareczny
ReviewerAshlee Zareczny is a licensed Medicare agent dedicated to helping those eligible for Medicare find the best coverage options.