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Ashford Insurance

Can I Get Medicare if I Have Existing Health Problems?

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Sarah Fuhrmann

Sarah Fuhrmann is an agent of Ashford Insurance an independent health insurance agency specializing in Texas Medicare insurance.

If you've had health issues before you turned 65, you might be wondering if you can still get Medicare. Well, the good news is that having pre-existing conditions won't stop you from getting Medicare coverage. In this simple guide, we'll break down everything you need to know about getting Medicare when you have existing health problems.

Can I Get Medicare if I Have Existing Health Problems?

If you’ve had health issues before you turned 65, you might be wondering if you can still get Medicare. Well, the good news is that having pre-existing conditions won’t stop you from getting Medicare coverage. In this simple guide, we’ll break down everything you need to know about getting Medicare when you have existing health problems.

What Are Pre-Existing Conditions?

Pre-existing conditions are health problems like asthma, diabetes, or cancer that you had before you applied for Medicare. Some other examples include lupus, depression, epilepsy, acne, anxiety, and sleep apnea.

Will Pre-Existing Conditions Affect My Medicare Eligibility?

No, your eligibility for Medicare won’t be affected by pre-existing conditions. Medicare doesn’t care about your health history. You can apply for Medicare Part A, Part B, or Part D without worrying about being denied because of your existing health issues. The important thing is to apply at the right time.

How Do I Sign Up for Medicare with Pre-Existing Conditions?

To enroll in Medicare with pre-existing conditions, you should apply during what’s called the “Initial Enrollment Period.” This period is different for everyone but generally starts three months before you turn 65 and ends three months after your 65th birthday. Missing this window might lead to extra costs, so make sure you apply on time.

If you miss your Initial Enrollment Period, you can still sign up between January and March each year, but there might be a late enrollment penalty unless you qualify for a special enrollment period. If you’re unsure about your situation, check the Medicare website or see if you qualify for automatic enrollment if you’re already receiving Social Security benefits before turning 65.

Does Medicare Cover My Pre-Existing Conditions?

Yes, Medicare will cover your pre-existing conditions, regardless of when you got them. Medicare will treat your existing health issues within the boundaries of your plan. However, if your condition falls outside of these boundaries, you’ll need to cover those costs yourself. That’s where Medigap or Medicare supplement insurance can come in handy.

What Is Medigap Insurance?

Medigap is insurance that fills in the gaps left by the Original Medicare Plan. It helps pay for healthcare costs that Medicare doesn’t cover. To have Medigap, you need to have both Medicare Part A and Part B and pay their premiums, along with the premium for Medigap, which is provided by a private insurance company.

Can I Get Medigap with Pre-Existing Conditions?

Just like with Medicare, federal law prevents private insurers from denying Medigap coverage to people with pre-existing conditions. However, when you enroll matters, so be sure to sign up during an enrollment period that doesn’t ask about pre-existing conditions.

In Conclusion

Getting Medicare when you have pre-existing conditions is absolutely possible. Remember these key points:

  1. Pre-existing conditions won’t prevent you from getting Original Medicare coverage.

  2. Know your Medicare Initial Enrollment Period and apply during that time.

  3. Medicare will cover your pre-existing conditions within plan limits.

  4. You can apply for Medigap through private insurers as long as you have Medicare Part A and Part B.

  5. Like Medicare, Medigap won’t deny you coverage due to pre-existing conditions.

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Picture of Sarah Fuhrmann

Sarah Fuhrmann

Sarah Fuhrmann has been helping Medicare eligibles in Texas with their Medicare Insurance since 2018.