Do Original Medicare, Medigap, and Medicare Advantage Cover Preexisting Conditions?

Do Medicare supplement plans cover preexisting conditions?

Medicare supplement plans (Medigap plans) are offered by private companies approved by Medicare. Medigap plans cover some of the costs not covered by original Medicare, such as deductibles, coinsurance, and copayments.

If you purchase a Medigap plan during your open enrollment period, even if you have a preexisting condition, you can get any Medigap policy sold in your state. You cannot be denied coverage and you will pay the same price as people without a preexisting condition.

Your open enrollment period for Medigapcoverage starts the month you are 65 and/ or enrolled in Medicare Part B.

Can you be denied Medigap coverage?

If you apply for Medigap coverage after youropen enrollment period, you might not meet medical underwriting requirementsand could be denied coverage.

Does Medicare Advantage cover preexisting conditions?

Medicare Advantage plans (Medicare Part C) areoffered by private companies approved by Medicare. These plans are bundled toinclude Medicare Parts A and B, usually Medicare Part D, and often additionalcoverage such as dental and vision.

You can join a Medicare Advantage plan if you have a preexisting condition unless that preexisting condition is end stage renal disease (ESRD).

Medicare Advantage Special Needs plans

Learn more

Medicare Advantage Special Needs Plans (SNPs) include Medicare Parts A, B, and D and are only available for people with certain health conditions such as:

  • autoimmune disorders: celiac disease, lupus, rheumatoid arthritis
  • cancer
  • certain, disabling behavioral health conditions
  • chronic cardiovascular disease
  • chronic drug dependence and/or alcoholism
  • chronic heart failure
  • chronic lung disorders: asthma, COPD, emphysema, pulmonary hypertension
  • dementia
  • diabetes mellitus
  • end stage liver disease
  • end stage renal disease (ESRD) requiring dialysis
  • hematological disorders: deep vein thrombosis (DVT), sickle cell anemia, thrombocytopenia
  • neurological disorders: epilepsy, multiple sclerosis, Parkinson’s disease, ALS
  • stroke

If you become eligible for an SNP and there’s a local plan available, you can enroll anytime.

If you no longer qualify for a Medicare SNP, you can change your coverage during a special enrollment period that starts when you are notified by your SNP that you’re no longer eligible for the plan and continues for 2 months after coverage has ended.


Original Medicare — Part A (hospital insurance) and Part B (medical insurance) — covers preexisting conditions.

If you have a preexisting condition, consider signing up for a Medigap plan (Medicare supplement plan) policy.

Medigap offers an open enrollment period during which you cannot be denied coverage, and you will pay the same price as people without preexisting conditions. You could be denied coverage if you enroll outside of your open enrollment period.

If you’re considering a Medicare Advantage plan, depending on your preexisting condition, you may be directed to a Medicare Advantage Special Needs plan (SNP).

Read more on: medicare