Medicare is health insurance that is offered by the federal government for the people of 65 or more years. It provides them coverage for their healthcare needs; however; it does not cover all of Medicare supplement planstheir healthcare expenses. The out-of-pocket expenses which are not covered under Medicare are covered by separate plans that are referred to as Medicare Supplement Plans or Medigap. These plans cover out-of-pocket expenses, i.e. coinsurance, copayment, and deductibles. Medigap is considered as an add-on or supplement to Original Medicare as it fills the gap between the coverage of Original Medicare and your actual healthcare needs. If you have any pre-existing condition before applying a Medicare supplement insurance plan, then it may contain the hazard of being denied by the Medicare supplement plan. So, before applying for a Medicare supplement insurance plan, it is important to know the following questions:

  • What do you mean by pre-existing conditions?
  • How may these pre-existing conditions affect your capacity to get coverage for out-of-pocket expenses?
  • When should you apply for Medigap policy if you have a pre-existing condition?
  • Will your Medigap plan admit your pre-existing condition?
  • Will the insurance company charge more for the Medigap plan for such conditions?
  • Will these conditions be covered under the Medicare supplement insurance plan?


Can You Be Denied Medicare Supplement Insurance?

While considering buying a Medicare supplement insurance plan, you have to know your capacity to get coverage due to pre-existing conditions. Can your Medicare supplement insurance deny your coverage? The answer to this question depends on your understanding of pre-existing conditions, the time period to apply for Medicare supplement plans, the premium charged for Medigap plan due to pre-existing conditions and pre-existing waiting time period. Once in awhile insurance companies accept your coverage even if you have any pre-existing condition. Conversely, sometimes your Medicare supplement insurance may deny your coverage or charge you more for your healthcare coverage.


What Do You Mean by Pre-existing Condition?

Pre-existing condition refers to any condition and illness that you have before applying and receiving coverage for your healthcare needs including different types of ailment or injuries, i.e. cancer, heart ailment, asthma, pain, high blood pressure, diabetes, swelling, and many more. These conditions are publically very common in most people. Research reveals that almost 50-70% of people among the 55-65 years older people have any pre-existing condition. Moreover, these conditions have a tendency to be prolonged and enduring.


Enrollment time periods for Medicare Supplement Insurance Plan:

There are different times available for the enrollment of Medicare supplement plans, i.e. open enrollment and after open enrollment. The enrollment time for Medicare supplement insurance has a strong impact on exactly how your coverage works.

  •      Open Enrollment:

Open enrollment is considered as the best time period to get enrollment for a Medicare supplement insurance plan. This time period starts when your age turns 65 years, and you sign up for Medicare Part B. The open enrollment time period remains tills six months after your 65 birthday. During the six months open enrollment time period, insurance companies cannot deny or refuse your coverage or charge you more for any pre-existing condition. The enrollment in a Medicare supplement insurance plan will alleviate the hazard of being dropped for pre-existing coverage.

  •      After Open Enrollment:

You can also sign up for a Medicare supplement insurance plan once the open enrollment time comes to an end. When you apply enrollment for Medigap plans after the open enrollment, an insurance company has an obligation to provide you coverage for pre-existing conditions only if you have a guaranteed right issue also referred to as Medigap protection. If you do not have a guaranteed right issue, then the insurance company may deny your coverage or charge you more for your pre-existing condition.

You would be eligible for guaranteed right issue for Medicare supplement plans in certain situations:


  • Your Medicare supplement insurance may mislead and deceive you. Need help? Get quotes by visiting
  • Your Medigap plan may involve any fraud or expired as bankrupt.
  • You drop or release your Medigap plan for a one year trial of Medicare Advantage Plan, and now you want to switch back to your Medigap plan.
  • Your Medicare Advantage Plan is not properly working in your area.
  • You change your location from a location covered under Medicare Advantage Plan.


Pre-existing Waiting Period:

Although you can sign up for Medigap plan if there is a lack of guaranteed issue right while applying for Medicare supplement plans. However, you have to wait for covering your pre-existing condition. This waiting time is referred to as a pre-existing waiting period. This time period continues for six months and only applies to your health condition that you have before the start of your Medigap plan. You can avoid the pre-existing waiting period in two situations, i.e. guaranteed right issue and open enrollment. When you apply for Medicare supplement insurance during these situations, an insurance company can’t impose a pre-existing waiting period for your coverage under pre-existing conditions.



Why is Open Enrollment Time best?

The open enrollment time period is considered as best and important as, during this time period, medical underwriting is not used by insurance companies to offer you Medicare supplement insurance plans and coverage for your pre-existing healthcare condition. Medical underwriting means that the insurance companies take information for your healthcare condition or health history to evaluate your application for a Medigap plan. Moreover considering health history and its coverage costs insurance companies may deny your coverage due to pre-existing conditions. During the open enrollment period, you can easily apply for Medicare supplement plans and your coverage would be guaranteed.


Other considerations:

There are some other situations under which an insurance company can deny your Medicare supplement insurance and not sell you a Medigap plan if:

  • You do not have enrollment in Medicare Part A.
  • You do not sign up in Medicare Part B.
  • You already enrolled in the Medicare Advantage Plan.
  • You have a Medicaid plan.


Bottom Line:

An insurance company cannot deny or refuse your coverage for Medicare supplement insurance or charge you more for your covering any of your health conditions that you already have before receiving your Medigap plan if you get enrollment in Medicare supplement plans during the open enrollment period. Conversely, if you apply for enrollment in Medicare supplement insurance after open enrollment (with the exception of guaranteed right issue), your coverage can be denied by the insurance company. Nonetheless, when you have a Medigap plan, the insurance company has an obligation to renew it regardless of any healthcare issue that you have.