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How to Learn if Your Pre-Existing Conditions Are Covered By Medicare

by Anita Ginsburg
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If you are covered by Medicare or are hoping to have this coverage sometime in the near future, you are probably hoping that a lot of your healthcare costs will be covered. If you have pre-existing conditions, however, you might be worried that this will not be the case. These are some of the things you should do if this is something that you’re worried about.

Make Sure You Qualify for Medicare

Of course, you must first determine whether or not you qualify for Medicare or if you will qualify for this coverage in the near future. To be eligible for premium-free Medicare Part A, you must be at least 65 years of age and if you or your spouse worked and paid Medicare taxes for at least 10 years. Some younger people also qualify for Medicare Part A if they have certain disabilities or if they have end-stage renal disease. If you are eligible for Medicare Part A, then you will also be eligible for Medicare Part B.

Think About the Type of Medicare Coverage That You Have

You do not have to worry about pre-existing conditions not being covered by Medicare. However, if you have a Medicare supplement plan — which many people choose to have to help cover some of the gaps that Medicare does not pay for — then you should know that pre-existing conditions can sometimes be a problem. Although insurance companies that sell Medicare supplement plans are not allowed to charge you higher premiums because of pre-existing conditions, they can exclude coverage for certain conditions for the first six months that you have coverage. If you have a Medicare Advantage plan, you do not have to worry about pre-existing conditions being a problem.

Consider When You Purchased Your Health Plan

If you do have a Medicare supplement policy, you should consider when you purchased it. If you purchased your plan before the Affordable Care Act, and if your plan has not changed significantly since then, then your pre-existing conditions might not be covered. This could be because your plan is considered to be “grandfathered in.” If you contact your insurance agent, they should be able to give you more information. If your pre-existing conditions are not covered because you have an older plan, then you do have the option to purchase a different plan. You may be able to purchase a different plan from the same insurance company or another company.

As you can see, there are a few things you can do if you are concerned about your pre-existing conditions not being covered by Medicare. Your insurance agent or Medicare case worker can give you more information, too.

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