Have Pre-Existing Conditions? Your Guide to Getting a Medicare Supplement Plan

Having a pre-existing condition used to be a serious problem for people looking for health insurance. Fortunately, the passage of the Affordable Care Act in 2010 changed that for people purchasing private insurance. But what about Medicare beneficiaries? Medicare Parts A and B cover anyone who paid into these programs, but what about Medicare Supplement Plans? Can you be denied for these plans – or charged more for one – if you have a pre-existing condition? With pre-existing conditions affecting an estimated 53.8 million adults 65 and older, this is an important question.article title and clipboard that says pre-existing conditions on a blue background

What Is Considered a Pre-Existing Condition?

Almost any illness or injury you had prior to enrolling in your insurance plan can be considered a pre-existing condition. The list is long but some of the most common ones are cancer, diabetes, end stage renal disease, and stroke. Not all pre-existing conditions are as serious, though: things like asthma, sleep apnea, and lupus can be pre-existing, too.

When it comes to Medicare specifically, for a condition to be considered a pre-existing, you have to be diagnosed and begin treatment before your Medicare start date. Even if you don’t receive a diagnosis before enrollment, your condition can still be count as pre-existing. For example, if you have a condition with emergent symptoms that the average person would have already had treated, your insurer can classify it as pre-existing. 

What Are Medicare Supplement Plans? 

Medicare Supplement Plans are insurance plans offered by private companies. They help cover the out-of-pocket costs of Original Medicare. While Medicare covers most of your health services it won’t cover everything: for example, Medicare Part B only covers 80% of medical services, leaving you to pay a 20% coinsurance. But if you have a Medicare Supplement Plan, this coverage will kick in and pick up the remaining costs.

Medicare Supplement Plans cover a number of things like copays, coinsurance, and deductibles, meaning you’ll only have to pay a low monthly premium. Some Medicare Supplement Plans even cover care you receive outside of the country, which Original Medicare won’t cover at all. 

Can I Get a Medicare Supplement Plan with a Pre-Existing Condition?medical record paperwork on desk

Fortunately, the answer to this is yes! You can get a Medicare Supplement Plan even with pre-existing health issues. Companies that offer these plans are usually able to use underwriting to determine your eligibility. Luckily there is a way around it. It all depends on when you sign up for your plan.

The best time to get a Medicare Supplement Plan without worrying about being denied or paying more for your plan because of health issues is during your Medicare Open Enrollment Period. This period begins the first day of the month your Medicare Part B. And is in effect and lasts for 6 months. 

Your Open Enrollment Period is the best time to get Medicare Supplement Insurance with pre-existing conditions. During this time, you have something called a guaranteed issue. This means that insurers have to offer you the best rates available. And they can’t deny you based on your health.

If you miss your Open Enrollment Period, you can still get a Medicare Supplement Plan.  But you may run into problems like high premiums or a 6-month waiting period. This means that you will have to pay for expenses related to your pre-existing condition for 6 months. Once that waiting period is over, your Medicare Supplement Plan will start covering your costs as normal.

Some states do offer additional enrollment periods though, so check with your state’s Medicare office. Additionally, if you qualify for a Special Enrollment Period, you can skip the pre-existing condition waiting period.

How Do I Qualify for a Special Enrollment Period?a bunch of gray question marks piled together with one blue and one orange question mark in the pile

 If you’ve missed your Open Enrollment Period, you can still get a plan with the better rates. There are a number of circumstances that can trigger a Special Enrollment Period. During which you can get a new Medicare Supplement Plan:

  • Your employer’s supplemental insurance ends, or benefits are reduced
  • Your Medicare Advantage Plan changes or ends its terms
  • You move out of your plan’s coverage area
  • Your Medicare Supplement Plan insurer commits fraud
  • You are utilizing your “trial right” within 12 months of applying for a Medicare Advantage Plan for the first time

Need Help?

Enrolling in a Medicare Supplement Insurance plan with pre-existing conditions can be tricky. If you need help navigating the enrollment process, EZ.Insure is here to help! Our highly trained insurance agents are always available to help you with any questions. We also provide free instant quotes. Simply put your zip code in the bar above, or you can speak to an agent directly, just call 888-753-7207.

Co-written by Brianna Hartnett

What Is Simplified Issue Life Insurance?

As we age, we can all develop health problems, which can make finding affordable life insurance an issue. If you have pre-existing conditions, life insurance companies could either deny you coverage or raise the price of your premiums. The greater the risk it is to cover you, the higher the price for whole life insurance or traditional term life insurance policies. But there is still hope even if you do have pre-existing conditions! There is a way to be approved for life insurance with minimal health questions and without medical exams: look into a simplified issue life insurance policy.

What Is Simplified Issue Life Insurance?

clipboard with a questionnaire on it and pens next to it
You will need to answer a couple of questions about your health, and will get immediate coverage after applying.

Simplified issue life insurance is a type of whole life insurance, meaning your policy will remain in effect for your entire life. Unlike most whole life insurance policies, simplified issue life insurance is meant for people who need or want life insurance right away and do not want to go through a medical exam. To obtain one of these policies, you simply need to answer a few questions about your health, and will get coverage almost immediately after you apply. 

So what’s the catch? Well, with simplified issue life insurance, you can expect higher premiums for less coverage. You will pay more because your insurance company will not get a full view of your health status and will be unable to fully determine how much of a risk you are. With these policies, you will get a death benefit payout anywhere from $5,000 to more than $100,000. However, it is important to note that some health conditions can actually prevent you from getting coverage. 

How It Works

In order to get a simplified issue policy, you will have to fill out a short health questionnaire so that your insurance company can complete a modified risk assessment and set a premium and death benefit. Unlike traditional whole life insurance, most simplified issue life insurance policies do not have a cash value that builds over time. To qualify, you must be between 45 and 85 years old. You could be denied coverage if you:

  • Are bed-ridden, or in a long-term care facility or nursing home
  • Require a wheelchair or oxygen equipment
  • Have been diagnosed with Alzheimer’s, dementia, or congestive heart failure
  • Are being treated for an organ or bone marrow transplant
  • Have been diagnosed with any form of cancer in the past 2 years
  • Have a terminal condition
  • Have been diagnosed with heart disease in the past year (12 months)
  • Have had heart surgery in the past year (12 months)

If you are denied coverage because of any of the above mentioned issues, you still have options. For example, you can look into a guaranteed issue whole life insurance policy. The best way to find the coverage that is right for you is to compare plans from multiple insurance companies. 

blood pressure cuff on the wall in doctor's office
One of the perks is that you will not need a medical exam when applying for a simplified issue life insurance plan.

Advantages of Simplified Issue Life Insurance

  • No medical exam or lab tests are required.
  • Once your application is filled out, you will get an instant decision. If approved, you will not have to wait weeks or months for coverage to begin, as with other life insurance policies. Instead, your coverage will begin as soon as you pay your first premium. 
  • These policies are cheaper than guaranteed issue whole life insurance, and offer higher death benefits than guaranteed issue policies. 

Is It Right For You?

Simplified issue life insurance might be a good fit for you if:

  • You have a pre-existing medical condition (that isn’t disqualifying).
  • You do not want to undergo a medical exam, which could delay coverage and raise the price of your premiums. 
  • You want life insurance but aren’t sure you will qualify for traditional life insurance policies.
  • Your term life insurance policy has expired.
  • You don’t want your family to worry about final expenses or debts when you are gone.

Pre-existing conditions are extremely common; in fact, according to Health and Human Services, 61 to 133 million Americans have some kind of pre-existing condition. Having one of these conditions does not necessarily mean you are disqualified from getting life insurance, which is a necessary financial asset for your family. There are many different life insurance plans to choose from, and even with health conditions, you can find an affordable plan with great coverage. Consider using online tools, or speaking with an agent. We have provided the top insurance companies that offer simplified issue life insurance policies below; each can give you hassle-free assistance and the most competitive rates in the nation. Always check multiple sites to make sure you have bargaining power and know the advantages of each company. Make sure a hard time isn’t made harder by a financial burden, check simplified issue life insurance rates today.

Life Insurance & Pre-existing Conditions

Having a pre-existing condition is very common; in fact, according to the Centers for Medicare and Medicaid Services (CMS), half of Americans under the age of 65 have at least one pre-existing condition. Unfortunately, when it comes to life insurance, pre-existing conditions can affect your coverage options. It’s no secret that the healthier you are, the less expensive a policy will be. But the good news is that having a pre-existing condition will not disqualify you from getting a plan. With a little bit of knowledge about how getting life insurance with a pre-existing condition works, and some help from a qualified agent, you can find a plan that will work for you. 

What Is A Pre-Existing Condition?

A pre-existing condition is a health issue that you were diagnosed with or treated for before applying for insurance. Each insurance company has its own set of rules when it comes to these conditions. Some of the most common pre-existing conditions in the U.S. include:

a light blue colored inhaler
Asthma is one of the common pre-existing conditions that can affect life insurance costs.

Generally, if you have one or more of the conditions mentioned above, you will raise a red flag with  life insurance companies. Don’t lose hope though – having one of these conditions does not mean you can’t find a great affordable plan. 

How Pre-Existing Conditions Affect Life Insurance Costs

When you apply for life insurance, the insurance company’s underwriters will collect your medical history, and some will require you to undergo a medical exam. They do this to get a good idea of your lifestyle (such as if you’re a smoker or drinker) and current health before they agree to take you on as a risk. Depending on any pre-existing conditions that you have, they might raise your premiums. Your rates will be based on the following scale:

  • Super Preferred, or Preferred Plus- These are the lowest rates
  • Preferred
  • Standard, or Regular
  • Substandard- These are the highest rates

Many people will qualify for super preferred, but if you have a serious health condition that could be considered life threatening, you will most likely qualify for substandard rates. The higher a risk you are considered by your insurance company, the more you will have to pay, since your life expectancy would be presumed to be shorter than that of a healthy individual. For example, health issues including Type 1 and Type 2 diabetics can lead to substandard rates. Other conditions that can trigger a substandard rate are Multiple Sclerosis, Crohn’s Disease, history of cancer or stroke, or Hepatitis C.

It is important to note that not all insurance companies rate conditions the same; for example, one company might see asthma as a serious condition, while another company might not increase your rates if you have it. If you have any preexisting conditions, working with a licensed agent who knows which insurance companies will cover you at an affordable rate is definitely the way to go. 

How To Lower Your Rate

a woman and 2 men running on a treadmill next to each other
Exercising and losing weight can help lower your life insurance rates.

Even if you have a pre-existing condition, there are things you can do to increase your chances of getting life insurance, and to lower your rates. The best things you can do are making lifestyle changes and trying to manage your condition. Consider doing the following:

  • Improve your health by following the treatment plan issued by your doctor for any medical conditions.
  • Exercise, which can help lower high cholesterol and high blood pressure, among other benefits.
  • Lose weight, especially if you are obese, which can affect your health and life expectancy. 

The Best Life Insurance For Pre-Existing Conditions

Don’t assume you will be turned down for life insurance just because you have pre-existing conditions. Some insurance companies offer policies that cater to individuals with specific health conditions. In addition, there are many different kinds of life insurance policies that you can qualify for. For example, if you cannot get a permanent life insurance policy (which builds cash value over time), you can opt for a guaranteed issue life insurance policy, which was designed for people with severe or multiple health conditions. Unlike whole life, guaranteed issue life insurance does not build cash value over time, you simply make monthly payments in exchange for a fixed amount to be paid out upon your passing. 

You can also choose to purchase a term life insurance policy for anywhere from 10 to 30 years and lock in the rates for that term. These policies are a more affordable option that you can get even with pre-existing conditions, as long as you are receiving treatment for your conditions and have them under control.

When looking for a life insurance policy, it’s best to work with an agent who is familiar with the underwriting process and standards for each medical condition that you might have. They will advocate on your behalf and will find you the best plan for you and your budget. 

Remember, life insurance is an important financial security blanket for your family. And just because you have a pre-existing condition does not mean you can’t find a great plan that will help secure their future. We have listed some of the top-rated insurance companies below, so check your rates today and find out what you can do to get approved or lower your current rates!

Missed Open Enrollment? Consider A Short-Term Plan

Was your fall so busy with work and holiday prep that you totally missed Open Enrollment? The Open Enrollment Period began November 1 and ended December 15, and, for some, a little over a month to sign up for health insurance is barely enough time! You were probably too busy to even begin researching plans, or maybe you were simply unaware of when you can sign up for health insurance. But no need to worry, EZ has a solution for you. You can sign up for a short-term plan, which will give you coverage until the next Open Enrollment Period.

woman sitting in front of a laptop with her pointers at the bridge of her nose while her eyes are closed

Special Enrollment Period

Before we look at short term plans, you should know that the only way to get most full-coverage health insurance plans outside of Open Enrollment is if you have experienced a qualifying life event. Qualifying life events include getting married, adding a family member, moving, getting divorced, etc. Experiencing one of these events will open up a Special Enrollment Period for you. You will then have 60 days to sign up for a new plan. 

Short-Term Plans

If you do not qualify for a Special Enrollment Period, the next step is to consider a short-term plan. These plans are much cheaper than ACA plans, but do not offer as much coverage. They are worth considering, though: short-term healthcare plans provide fast, flexible insurance with many benefits. You are able to pick your deductible amount from many options. And you are able to drop coverage without a penalty for a long-term insurance option.caucasian hand with a bubble over it with a stethoscope in the bubble.

You can get one of these policies at any time and it will cover you for 364 days. It is important to note that they do not have to cover pre-existing conditions, so premiums can be based on your medical history. These plans are considered minimum essential coverage, because they are not regulated by the Affordable Care Act. Because they are not subject to ACA rules, these plans do not have to include the ACA’s 10 essential health benefits, such as:

  • Ambulatory patient services
  • Emergency services
  • Hospitalization
  • Pregnancy, maternity, and newborn care (both before and after birth)
  • Mental health and substance use disorder services, including behavioral health treatment
  • Prescription drugs
  • Rehabilitative and habilitative services and devices
  • Laboratory services
  • Preventive and wellness services, and chronic disease management
  • Pediatric services

Choosing a short term health insurance will save you money. However, make sure you know what you are purchasing, and make sure that it is the right choice for you.

outline of a piggy bank with a coin going into it
EZ will find an affordable plan that will save you the most money.

Get Insured While Saving

Missing the Open Enrollment Period is more common than you might think, so don’t feel alone. Even though you missed it, you do not have to go uninsured. EZ.Insure wants to make sure that you are protected from any catastrophic and unexpected healthcare emergencies. We will compare all available short-term plans in your area to find a plan that gives you the most coverage with the most savings. And because we just want to make sure you are properly insured, we offer all of our services at no cost to you. We will provide you with your own personal agent who will go over your needs and find a great short-term plan that can temporarily insure you until the next Open Enrollment Period. To compare quotes, simply enter your zip code in the bar above, or to speak to a licensed agent, call 888-350-1890.

Can You Get Health Insurance at Any Time?

If you are unhappy with your current health insurance policy, then it might be time to shop for a different plan. But can you purchase a new plan at any time? Yes, and no. For marketplace plans, once the open enrollment period (November 10 to December 15) is over, you generally cannot get a new plan. The open enrollment period for employer-based insurance might be at a different time of year, but you will still only be able to change your plan during that enrollment period. In most cases, if you want to get health insurance or change your plan outside of the open enrollment period, you will need to qualify for a Special Enrollment Period (SEP). SEPs open up when you experience what is known as a qualifying life event. 

Qualifying Life Events

caucasian couple hlding a baby girl in the middle while both are kissing each cheek
You can get health insurance outside of open enrollment if you qualify for SEP such as getting married or having a baby.

You have 60 days to change your plan if you:

  • Got married
  • Had a baby, adopted a child, or took in a foster child
  • Got divorced or legally separated. However, if you do not lose coverage due to divorce or legal separation, then you do not qualify for a Special Enrollment Period.
  • Had someone on your marketplace plan die
  • Changed residence. If you move to a new home in a new ZIP code or county, move to attend school, are a seasonal worker and move between job and home, or move from a shelter or other transitional housing to a permanent residence, you will qualify for an SEP.
  • Lost your health insurance. This includes losing job-based coverage, losing a plan you bought yourself, losing eligibility for Medicaid or Medicare, and losing coverage through a family member.
  • Gained membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder
  • Became newly eligible for Marketplace coverage because you became a U.S. citizen
  • Left incarceration
  • Started or ended service as an AmeriCorps State and National, VISTA, or NCCC member

Short-Term Medical Plans

If you do not qualify for any of the life events listed above, all hope is not lost. You can enroll in a short-term medical plan. Short-term health insurance provides fast, flexible insurance with many benefits. These plans can be extended up to 3 years, and you can pick your deductible amount from many options. You are also able to drop coverage without a penalty if you want to change to a long term insurance option. Premiums are lower than ACA health insurance plans, and you get coverage as soon as a day after applying.

short-term health insurance form on a clipboard

It is important to understand that short-term insurance is temporary and not ideal for those who require more comprehensive coverage or have health conditions. Short term plans are not guaranteed-issue, meaning they do not cover pre-existing conditions. They only cover the basics.

Do you qualify for a special enrollment period? If not, are you considering a short-term health insurance plan to hold you over until open enrollment begins? EZ.Insure can help. We offer accurate health insurance quotes based on your specific region, free of charge. That’s right. We will provide you with an agent who will compare all available plans for you, and help you choose a health insurance plan that is based on your health needs and budget, for free. To get your free quotes, simply enter your zip code in the bar above, or to speak to an agent, call 888-350-1890.

Does Trumpcare Exist?

When President Trump took office, one of his campaign promises was to get rid of Obamacare also known as the Affordable Care Act (ACA), and replace it with new health care. Trump delivered on this campaign promise, providing Americans with Trumpcare, also known as the American Health Care Act (AHCA). Trumpcare was voted on, and passed in the House on May 4, 2017. Since being passed, the number of Americans getting health insurance has gone up by 7 million. There are some similarities between Obamacare and Trumpcare. So why have Americans been signing up for insurance more now with Trumpcare?

Chart with blue bars increasing in size with a red line drawn over them.
Since Trumpcare was introduced, more Americans have been signing up for health insurance.

Short Term Plans

Short term plans used to have limitations of 3 months. As of October 1st, 2018, the short term health plans have a one-year policy term. Short term health insurance provides fast, flexible insurance with many benefits. You may pick your deductible amount from many options. You are also able to drop coverage without a penalty for a long term insurance option. Premiums are lower than ACA health insurance plans, and you get coverage as soon as a day after applying. 

Once someone signs up for a one-year short term plan, they may potentially renew it for up to three years. Insurers can ask medical questions and possibly reject consumers due to pre-existing conditions for a short-term policy. Once approved for the plan, if a consumer develops a ‘pre-existing condition’, rejection can occur during the renewal process

Individual Mandate

Obamacare enforced an individual mandate penalty for Americans who did not have insurance. The individual mandate was the requirement of people to obtain health insurance for the year, and if not then you had to pay a penalty during tax season. In December 2017, President Trump eliminated the individual mandate from Obamacare. Trump did away with the individual mandate because Republicans believed it discouraged people from buying insurance that costs just as much as the uninsured penalty. 

Pre-existing Conditions

Like Obamacare, Trumpcare protects people with pre-existing conditions. People who stay insured, without a gap in coverage, will not pay a price for health insurance based on pre-existing conditions. No insurance plan can reject you, charge you more, or refuse to pay for essential health benefits for any condition you had before your coverage started. However, Trumpcare has given the states authority to change the pricing for people who do not stay insured

A sign with "health" on it point to the right with another sign below it saying "illness" pointing to the other.
Pre-existing conditions are covered under Trumpcare, but people with them may have to pay more.

year round. In other words, once you choose to be uninsured, and stay uninsured for an extended period of time, you will face a higher rate for health insurance due to your pre-existing conditions. 

Federal Invisible Risk Sharing Program

Trumpcare created the Federal Invisible Risk Sharing Program. It is a pool of funds the government sets aside to assist insurance companies in covering people with high expenses (people with pre-existing conditions). The risk pools are invisible to the customer. This means that high medical cost individuals would not know they’re in the risk pool. They are expected to pay the same cost for insurance as healthy people.

Trumpcare does exist, and has been slowly replacing Obamacare. Getting rid of the individual mandate, and extending short term plan’s length has been Trumpcare’s biggest changes, and main focus. These changes were made in hopes of getting more Americans to sign up for insurance, because the more that people sign up (especially healthy people), then the lower the insurance costs will be. Since more Americans have been signing up for health insurance, hopefully the costs will begin to go down.