Learn How to Qualify for Medicare Supplement Plans

Learn How to Qualify for
Medicare Supplement Plans

To qualify for a Medicare Supplement plan, you must be age 65 or older (may vary by state), enrolled in Medicare parts A and B, and you must reside in the state in which you are applying for supplemental coverage.  You can sign up when you are 64 1/2, so that your coverage is in effect when you turn 65.

Open Enrollment:  Your open enrollment period that lasts for 6 months and begins on the first day of the month in which you are age 65 or older and enrolled in Part A and B of Medicare.  Some states have additional open enrollment periods.  There are no other qualifying questions during open enrollment, insurance companies can not use medical underwriting, and pre-existing health conditions do not matter. 

IMPORTANT:  If you do not apply during your open enrollment period, you application will be subject to an approval process called “underwriting.”  Because health insurance is designed primarily to cover you for the unexpected, a company may put an exclusion on pre-existing health conditions.  If you have cancer, heart disease, or other serious health conditions you will likely be declined.  Some companies also reserve the right to rate the premium up (charge more) to cover the cost of current medications.  IT IS VERY IMPORTANT THAT YOU APPLY DURING YOUR OPEN ENROLLMENT PERIOD IF POSSIBLE, at which time your application will NOT be subject to this underwriting process.  This means the insurance company must accept your application, and can not raise your premium or exclude coverage because of any pre-existing conditions you may have.

After Open Enrollment:  To help control rising costs, carriers apply the pre-existing condition clause to newly issued Medicare Supplement plans in most states.  Expenses resulting from a condition existing six months prior to the supplemental plan effective date are not covered unless they are incurred three months after the supplemental plan effective date.

If the supplemental plan replaces another creditable individual or group insurance coverage due to a person's eligibility for Medicare, this Pre-Existing Conditions Limitation will be reduced by the number of months that coverage was in force.  If this supplemental plan replaces another Medicare Supplement plan, this Pre-Existing Conditions Limitation will be reduced by the number of months that the coverage was in force.

The medical questions on the supplemental enrollment application address health conditions that would result in a rejected application.  If you have one of these conditions or have been advised by a doctor to treat these conditions using medications, X-rays, a surgical procedure (in-patient or outpatient), therapy, rehabilitation or doctor's visits, you should not apply for a Medicare Supplement plan until your next open enrollment period.

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