It depends. A pre-existing condition is a condition or illness you were diagnosed with or got treatment for before your new health care coverage began.
Under national laws, you may have up to a six-month waiting period for Medigap coverage of pre-existing conditions unless you are in one of the following situations:
- You are entitled to a guaranteed-issue right to buy a Medigap because you recently lost certain types of other coverage;
To learn when you have the right to buy a Medigap, click on the links in the GO TO box.
OR
- You purchased a Medigap during an open enrollment period and had coverage from one of the following types of insurance for at least six months prior to purchasing the Medigap and have had this prior coverage within the last 63 days:
- Medicare Parts A and B*
- Private health insurance coverage (including Medicare private health plans)
- Group health plan (like an employer plan)
- COBRA
- Medicaid
- CHAMPUS AND TRICARE (health care programs for the uniformed military services)
- Federal Employees Health Benefit Program
- A public health plan
- State health benefits risk pool
- Indian Health Service or Tribal Organization Program
- A health plan under the Peace Corps Act
- Veterans Administration benefits
Medigap insurers are required to reduce the pre-existing condition waiting period by the number of months an individual was covered under one of the types of coverage listed above, so long as there were no breaks in coverage of more than 63 calendar days.
If you had no previous health insurance coverage or you did, but you waited more than 63 days after it ended to buy a Medigap, the company can make you wait up to six months for coverage for health problems you already have.
If you are replacing a Medigap policy you have had for at least six months with a new Medigap policy, you will have no pre-existing condition waiting period for those benefits covered by your old plan. However, you may have a waiting period of any new benefits in the new plan you choose.
Not all plans impose pre-existing condition waiting periods. If you do not have coverage that is considered creditable, shop around to find a plan that does not make you wait for coverage of services to treat your preexisting conditions and offers coverage at an affordable price.
* In New York, credit for Medicare coverage is only given if you apply for a Medigap during the first six months after you turn 65 and are enrolled in Medicare.
