I have a pre-existing condition. Can I still use Medicare Advantage?

A pre-existing condition is a health condition or illness that exists before a person enrolls in a health insurance plan. Pre-existing conditions can range from minor to chronic conditions, such as asthma, diabetes, cancer, and heart disease. Under the Affordable Care Act (ACA), health insurance companies are prohibited from denying coverage or charging higher premiums based on a person's pre-existing conditions. This means that if you have a pre-existing condition, you can still enroll in a health insurance plan, including Medicare, a Medicare Advantage Plan and still receive treatment for your condition.

For Original Medicare Parts A and B beneficiaries, there are no pre-existing condition exclusions for coverage under Medicare Part A (hospital insurance) and Part B (medical insurance).

However, Medicare Part D prescription drug plans may impose a pre-existing condition waiting period for new enrollees who do not have prior creditable prescription drug coverage.

Creditable Drug Coverage is health insurance coverage that is at least as good as Medicare's standard prescription drug coverage. If you have creditable prescription drug coverage, you are currently not subject to a waiting period when you enroll in a PART D Prescription Drug plan .

It's important to note that original Original Medicare Parts A and B or Medicare Advantage may not cover all treatments for a pre-existing condition, and there may be limitations or restrictions on coverage for certain services or treatments.

Additionally, some pre-existing conditions may require Prior Authorizations or special approval from Medicare (CMS) before treatment is covered. Beneficiaries should review their plan's Summary of Benefits and Coverages to understand the specifics of their coverage for pre-existing conditions.

MedHelpCenter.us recommends that you call the Senior Health Insurance Agency at 813-592-8568 for further explanation.