ObamaCare: Medigap and Preexisting Conditions

Affordable Care Act and how it affects Medigap

by Ray Wilson+ on Oct 01, 2013 | 4 Comments

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ObamaCare, also known as the Affordable Care Act, has a provision that disallows preexisting conditions to be a factor in any new health plan. But how does this affect Medicare Supplemental insurance? We’ve got answers for you.

Medigap and Preexisting Conditions

If you enroll during the open enrollment period seniors do not have to worry about preexisting conditions. However, after this time, Medigap plans are not subject to the new ACA law that requires insurance companies to enroll persons regardless of preexisting conditions. This new law applies to the new Affordable Care Act plans: Bronze, Silver, Gold, and Platinum and off-Exchange plans.

What Medigap Covers

Medigap fills in the gaps that Original Medicare leaves open to the tune of $1 Mil a year. That is not a typo, my friends. Medigap Plan F can save seniors $1 Mil in a year.  Medigap covers things like Medicare Part A’s and B’s deductibles, coinsurance, and excess charges, as well as adding extras like foreign emergency care and gym memberships.

So basically make sure you sign up in the initial 6 month period that begins the first day of the month you turn 65. To sign up for a Medigap plan or if you have any further questions call 800-930-7956 or contact Senior65.

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Reader Comments and Questions

By vincent on October 20, 2017

I am 79 years old. I am employed and have health insurance at office. I am planning for retirement. I take medication for a partial artery blockage. If I sign up for medicare ans for a supplemental policy right before I retire do I have guaranteed coverage?

Based on the information you have shared you can be approved with guaranteed issued coverage when you retire. Please contact us and we can help you select the best plan for your needs and enroll you with no extra cost or hidden fee.
-Michelle from Senior65.com

By Ewald on August 01, 2017

I recieved my medicare due to a disability at age 51 ..... when I turn 65 will I have another pre existing waiting period. Thanks for your help.

In most states, when you turn 65, you will not have to worry about divulging preexisting conditions to enroll in a Medigap plan. The reason is: most enrollees during their initial enrollment period (even if they have had Medicare before) do not need to answer medical questions to be approved. If you need help finding a Medigap plan at 65, please call one of our Senior65 licensed independent insurance agents at 800-930-7956.
-Chris from https://www.senior65.com/

By Charles Donaldson on February 19, 2017

I am 71 years old, had Blue Care Network for seven years and they canceled me a month ago because I missed a payment. I have a pre-existing condition. Do they have the right to refuse to refuse me insurance now? Will I be guaranteed insurance in the open enrollment time at the end of this year.

Unfortunately, if you miss a payment, you can be denied coverage. Our suggestion is that you attempt to appeal this. If you are not able to appeal successfully, you can apply for another plan, but remember you can be denied or charged more for preexisting conditions.
-Amy from https://www.senior65.com/

By Kenneth on January 14, 2017

I signed up for a supplemental eight months after I turned sixty five. I have a pre-existing condition. Will the supplemental still cover the pre-existing condition if ACA is gone. At this time the supplemental insurance will cover it.

The good news is you were approved outside of your initial enrollment period and were able to get coverage, even with a pre-existing condition. The other good news for you is ACA plans and Medigap are completely separate -ACA is for non-Medicare enrollees. So you're good to go! Just make sure to make your premium payment on time, and you'll be able to keep your plan.
-Amy from https://www.senior65.com/

PLEASE NOTE: We cannot comment on specific Medicare claims. Contact Medicare directly if you are trying to see if your issue is covered.

We will not publish your last name or email if you submit this form.

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