- A pre-existing condition is a medical condition that an individual had before enrolling in a health insurance plan. Under certain circumstances, insurance plans may exclude coverage for treatment of pre-existing conditions or may require a waiting period before coverage for such treatment becomes effective.
- In the context of Medicare, pre-existing conditions are generally not a factor in determining coverage. Original Medicare (consisting of Part A and Part B) does not exclude coverage for treatment of pre-existing conditions, and beneficiaries are not required to undergo a waiting period before receiving coverage for such
treatment. - However, it’s important to note that Medicare Advantage plans, which are private health insurance plans that are an alternative to Original Medicare, may have different rules regarding pre-existing conditions. These plans are required to cover everything that Original Medicare covers, but they may have different out-of-pocket costs and may offer additional benefits.
- It’s important for beneficiaries to carefully review the terms of their Medicare Advantage plan and understand any potential limitations or exclusions that may apply, including any rules regarding pre-existing conditions.
- It’s important for beneficiaries to carefully review the terms of their Medicare Advantage plan and understand any potential limitations or exclusions that may apply, including any rules regarding pre-existing conditions.
