Free Consultation: Call (866) 590-9771
Close this search box.

Understanding Medicare Supplement Enrollment and Pre-Existing Conditions

As we have touched on in previous articles, Medicare Supplement can be the favored choice for some seniors beginning their Medicare journey.

Medicare Supplement policies bring comfort to seniors as these policies are designed to fill in the areas left uncovered by original Medicare. Things like deductibles, coinsurance, and copayments are covered by a Medicare Supplement plan, and annual out-of-pocket costs, if any at all, are known and can be budgeted for. Also, Medicare Supplement can offer a wider range of medical providers as Medicare Supplement enrollees are not limited to a network of physicians.

Agents should be aware of a couple of points about Medicare Supplement policies that will need to be discussed with seniors. In this article we want to look at when someone can purchase a Medicare Supplement plan and if that policy will cover any pre-existing conditions. Let’s start by looking at Medicare Supplement enrollment.

When to Enroll

The best time to purchase a Medicare Supplement policy is during an individual’s Open Enrollment Period. This period is not a set time in the calendar year for everyone to enroll but rather a unique enrollment timeframe for each potential enrollee.

To be in the Medicare Supplement Open Enrollment window, a senior must be 65 or older and enrolled in Medicare Part B. Once those terms are met, the Medicare Supplement Open Enrollment Period opens and continues for six months. It is a one-time enrollment period and does not open annually.

This is the opportune time to enroll in Medicare Supplement because restrictions are very limited and premium pricing is often better. Enrollees can obtain any policy during this period from any carrier.

It should also be noted that policy holders who have had Medicare plans end or be cancelled can obtain favorable enrollment terms through guarantee issue rights. These rights are available under certain conditions, even after the open enrollment for Medicare Supplement has passed.

If the Open Enrollment Period passes without a senior purchasing a Medicare Supplement plan, the senior can still get a Medicare Supplement policy, but some companies, through underwriting, can exclude the senior from coverage, and prices could be more expensive.
Agents, when working with potential clients, make sure you explain the importance of the open enrollment period and the benefits it can offer!

Pre-Existing Conditions

By obtaining a Medicare Supplement policy during the Open Enrollment Period, a senior can reduce the chances of pre-existing conditions not being covered by the policy. Some policies enforce a “look back” period, and any condition treated or diagnosed within up to six months prior to the policy being signed may not be covered.

But the senior would still be covered by Original Medicare and any co-insurance supplied by the Medicare Supplement policy would go into effect after the waiting period.

This waiting period is not in effect if the Medicare Supplement policy is replacing what is called “creditable coverage.” Examples of creditable coverage would be a group health plan, individual health insurance, student health insurance, Medicaid, and others. For a list of creditable coverages, click here.

How Agility Can Help

Agility offers many resources to help agents understand Medicare Supplement policies and present their clients with the best solutions.

With Agility Insurance Services on your side, you get top-flight support that allows you to offer Medicare Supplement plans. We also help you understand plan options and how to explain them.

As trusted insurance advisors, you have an opportunity to educate clients on how a Medicare supplemental insurance plan can protect their hard-earned savings from runaway medical costs in retirement.

This is the year you can boost your career by getting serious about offering Medicare Supplement and its many options to your members. Find out how to partner with Agility by visiting us on our Medicare Contracting page or contacting us at 866-590-9771.