Advertisement
insurance

How Preexisting Conditions Can Affect Medigap Insurance

In many cases, insurers can take preexisting conditions into account when deciding whether to sell you a medigap policy and what to charge you.

Question: Is it true that an insurance company can factor in preexisting conditions when deciding whether to offer you a medigap policy or when setting the premiums?

Answer: That’s correct. Many people don’t realize that even though preexisting conditions can’t affect your ability to get other types of health insurance, the rules are different for medigap. You can pick any medigap plan available in your area within six months after you initially sign up for Medicare Part B. But after that, medigap insurers in almost all states can reject you or charge more based on your health. This can make it difficult if you’d like to switch to another insurer with better medigap rates or if you had a Medicare Advantage plan for more than a year and want traditional Medicare and a medigap policy instead.

There are a few exceptions. A few states—including Connecticut, Massachusetts and New York—have special rules that let residents switch medigap plans regardless of preexisting conditions. Other states permit you to change plans at certain times. For example, Californians may select a different medigap plan that has the same or fewer benefits if they do it within 30 days after their birthday each year. You may also buy a medigap policy without concern about preexisting conditions if you move out of your Medicare Advantage plan’s service area or change your mind within 12 months of signing up for Medicare Advantage at age 65. For more information see Medicare.gov’s When Can I Buy Medigap?

Advertisement
Advertisement - Article continues below
Advertisement - Article continues below

Also, your insurer may let you switch to a less-comprehensive policy regardless of your health (such as switching from a Plan F to a high-deductible Plan F, for example). See the Medicare Rights Center’s list of what each type of medigap policy covers.

And if you’re healthy, you may still be able to qualify for a new medigap policy, especially if you’re in your mid to late sixties. You don’t need to wait until any specific time of year to apply for a new medigap policy because there is no annual open-enrollment period.

For more information about your state’s rules, see your state insurance department website. You can find links at www.naic.org/map. Most have consumer guides that list medigap prices and provide information for seniors searching for a plan. Your State Health Insurance Assistance Program can also help. See www.shiptacenter.org for links.

Advertisement

Most Popular

What Are the Income Tax Brackets for 2020 vs. 2019?
tax brackets

What Are the Income Tax Brackets for 2020 vs. 2019?

The IRS unveiled the 2020 tax brackets, and it's never too early to start planning to minimize your future tax bill.
June 20, 2020
65 Best Dividend Stocks You Can Count On
stocks

65 Best Dividend Stocks You Can Count On

These 65 Dividend Aristocrats are an elite group of dividend stocks that have reliably increased their annual payouts every year for at least a quarte…
July 8, 2020
Find a Great Place to Retire
happy retirement

Find a Great Place to Retire

Our cities provide plenty of space to spread out without skimping on health care or other amenities.
July 2, 2020

Recommended

Applying for Disability Benefits During a Global Pandemic
insurance

Applying for Disability Benefits During a Global Pandemic

It can take months or even years to get approved for Social Security Disability Insurance (SSDI) benefits in the best of times. Needless to say, now i…
June 24, 2020
Finding Affordable Health Care Now
insurance

Finding Affordable Health Care Now

The pandemic has caused millions of people to lose their jobs — and their health coverage. Here’s a guide to finding affordable insurance.
June 4, 2020
Medicare Now Covers Telehealth, Thanks to This Pandemic
retirement

Medicare Now Covers Telehealth, Thanks to This Pandemic

Many private health insurers have offered telehealth for several years, but Medicare lagged behind covering the service.
May 20, 2020
What Retirees Must Know About Telehealth
retirement

What Retirees Must Know About Telehealth

The coronavirus has elevated the benefits and potential savings of telehealth like nothing before.
May 20, 2020