Does Medicare cover preexisting conditions?

Preexisting conditions are health problems you had before applying for or enrolling in a new insurance plan. Some can be chronic diseases, such as diabetes, high blood pressure or cancer. Others can be mild conditions, such as seasonal allergies or acne.

Original Medicare (Part A and Part B) has helped cover preexisting conditions since it began in 1965. And thanks to the Affordable Care Act signed in 2014, there are no additional costs for Original Medicare coverage if you have preexisting conditions.

Let’s see how these conditions are handled by the different parts of Medicare.

Does Original Medicare cover preexisting conditions?

Yes. When you sign up for Original Medicare, any preexisting condition will be covered immediately. You’ll still be responsible for all out-of-pocket expenses like deductibles, copayments and coinsurance.

Does Medicare Advantage cover preexisting conditions?

Yes. Medicare Advantage (MA) plans won’t reject your enrollment if you have a preexisting condition. But since MA plans are offered by private insurance companies, coverage levels and costs can vary from company to company. 

Do Medicare Supplement insurance plans cover preexisting conditions?

Yes. However, a Medigap insurance company can refuse to cover pre‑existing conditions for up to 6 months after enrollment. This is called a “pre‑existing condition waiting period.” After 6 months, the Medigap policy will cover those conditions.

Note: The only way Medigap coverage can be denied for a pre-existing condition is if the condition was treated or diagnosed during the “look back period”—6 months before your Medigap policy coverage started.  

Original Medicare, provided by the U.S. Government, does help cover preexisting conditions. Medicare Advantage and Medigap plans, which are offered by private companies, have their own rules. To learn about Medigap plans with Humana, check out our Medicare Supplement Insurance plans today.