As you approach age 65, you should begin planning for your Medicare coverage. You will be able to choose from a variety of plans, from Original Medicare to Medicare Advantage to various Supplement (Medigap) plans. Naturally, you want to make the best choice regarding coverage, but your budget for out-of-pocket expenses is extremely important as well.
You might have heard that you can always switch plans later, if you decide your initial choices are wrong for you. That is technically true, because you can compare and select different plans during the Annual Election Period each year (and at certain other times, depending upon circumstances). However, with regard to pre-existing conditions, there is something important you need to know: In some cases you can be denied certain types of coverage later.
It all depends on the type of plan you initially select, and choices you might want to make later.
Medicare Advantage Plans and pre-existing conditions. Medicare Part C plans, or Advantage plans, will accept you regardless of pre-existing conditions (except end-stage renal disease). This is true at any time. So if you enroll in Original Medicare but later decide you’d rather use an Advantage plan, there is no problem with regard to pre-existing conditions. You can also switch from one Advantage plan to another.
Medicare Supplement (Medigap) plans can deny you based on pre-existing conditions. Now, let’s assume you sign up for Original Medicare when you first become eligible, but you forego the opportunity to enroll in a Supplement plan. Or, you initially select an Advantage plan but later decide you’d prefer Original Medicare with a Supplement plan.
You might find yourself disappointed, because Supplement plans are allowed to make decisions on the basis of pre-existing conditions. In many cases you will be denied coverage under these plans, for this reason.
What to do if you have pre-existing conditions when you reach Medicare eligibility. When you first enroll in Medicare, and for six months following, you can select Original Medicare with a Supplement (Medigap) policy regardless of pre-existing conditions. This is the time to make that decision.
Later, you might be able to enroll, but there is no guarantee that you will be able to do so. If you do have a pre-existing condition, work closely with a Medicare broker before you reach your initial eligibility. This is the best way to learn what to expect, so that you can carefully choose a plan that works best for you in the long term.
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