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Medicare and Pre-Existing Conditions
Short answer: yes. Original Medicare, Medicare Advantage Plans and Medicare drug plans cover people with pre-existing conditions. The main place your health history can matter is when you buy a Medicare Supplement (Medigap) policy outside certain protected times.
Original Medicare (Part A and Part B)
Original Medicare covers Medicare-covered services regardless of pre-existing conditions. There is no health screening to enroll.
Medicare Advantage (Part C)
Medicare Advantage Plans cannot deny you coverage because of a pre-existing condition. You must have Part A and Part B and live in the plan's service area. Some Special Needs Plans are designed for people with certain chronic conditions.
Medicare drug plans (Part D)
Part D plans cannot turn you down because of your health. In 2026, out-of-pocket costs for covered drugs are capped at $2,100 for the year. See Part D.
Medicare Supplement (Medigap)
During your 6-month Medigap Open Enrollment Period, which starts the first month you have Part B and are 65 or older, an insurer cannot refuse to sell you a policy or charge you more because of your health. It can, however, make you wait up to 6 months for coverage of a pre-existing condition if you did not have creditable coverage before. If you had at least 6 months of creditable coverage, that waiting period is reduced or removed.
Outside that window, insurers in most states can use medical underwriting, meaning they may ask health questions and can decline your application or charge more. You also have guaranteed issue rights in certain situations, such as losing other coverage. Some states give extra protections. A licensed agent can explain the rules where you live.
Frequently asked questions
Does Medicare cover pre-existing conditions?
Yes. Original Medicare, Medicare Advantage Plans and Part D drug plans all cover people with pre-existing conditions.
Can a Medigap company deny me for a pre-existing condition?
Not during your 6-month Medigap Open Enrollment Period or when you have a guaranteed issue right. Outside those times, in most states, insurers can ask health questions and may decline you or charge more.
Can a Medicare Advantage plan turn me down because of my health?
No. If you have Part A and Part B and live in the plan’s service area, a Medicare Advantage Plan cannot deny you because of a pre-existing condition.
What is a pre-existing condition waiting period in Medigap?
A Medigap insurer can make you wait up to 6 months before covering costs for a pre-existing condition if you did not have creditable coverage before. Prior creditable coverage can shorten or remove that wait.
Talk with a licensed agent
Questions about your Medicare options? Call 1-844-438-6284 (TTY 711) or request a free, no-obligation quote. We do not offer every plan available in your area.
Sources for 2026 figures: CMS 2026 Medicare Parts A & B Premiums and Deductibles; Medicare.gov: Medicare costs; Medicare.gov: Part D costs. For information on all of your options, contact Medicare.gov or 1-800-MEDICARE (TTY 1-877-486-2048).