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  • Steven Corn

Pre-Existing Exclusions Still Exist for Seniors

Updated: Oct 27, 2020

One of the biggest successes of the Affordable Care Act was the removal of pre-existing exclusions. No longer could insurance companies deny or charge more if you had pre-existing conditions. Since 25% of Americans have some form of chronic illness, this was a game-changer.

Many people believe that this applies to all types of health insurance. It may surprise many seniors (most of which have one or more pre-existing conditions) that this is not always the case. If you are turning 65 soon or just turned 65, please read this carefully:

What this means is that if you sign up for a Medi-Gap policy within 6 months of your 65th birthday, pre-existing conditions do not apply. But if you sign up for a Medi-Gap policy after that "open enrollment period", then the insurer can base your eligibility and costs on pre-existing conditions.

It is up to each insurer to decide. So if you miss the deadline, you should check on the policy benefits carefully when you choose such a plan.

(Note: this does not apply to original Medicare or Medicare Advantage plans which do not discriminate against pre-existing conditions.)

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