Will enrolling in Medicare three months after being eligible cover pre-existing conditions?

1 answer | Last updated: Sep 16, 2016
Michaael asked...

I reached 65 three months ago and became eligible for Medicare but did not apply. I will apply this week for Medicare A and B and Medigap. Last week I found out, I have cancer. Will Medicare A and B still cover my upcoming tests and treatment for this cancer even though it is pre-existing? Will Medigap cover this cancer treatment? I delayed getting Medicare because I can be treated by the VA but with poor outlook for the cancer I have, I would rather go to a Cancer Hospital like M D Anderson in Houston if Medicare will cover the operation and treatment.

Expert Answers

There is good news for you about coverage for preexisting conditions by Medicare, but you have to act quickly.

Neither Medicare Part A or Part B has any preexisting illness or condition exclusions at all. Once you are enrolled in Medicare, you get coverage to the full extent that anyone else does, regardless of when you became ill or began treatments. This is true even though you delayed enrolling in Medicare.

It is VERY IMPORTANT to know that you must enroll in Medicare Part B within three months of the end of the month you turn 65, or else you will have to wait until the next "open enrollment" period which falls during the first three months of each year. If you do not enroll until the open enrollment period, your coverage will be delayed until the following July 1. So, you need to enroll in Medicare right away or lose your chance at coverage until next year.

With regard to coverage for preexisting conditions, Medigap private supplemental insurance policies are a little different from Medicare. Whenever you first enroll in Medicare Part B, you have six months from that date to purchase any Medigap policy sold in your state, regardless of your health. If you buy a Medigap policy within that first six months, the Medigap insurance company may NOT either deny you a policy based on your preexisting condition or impose any coverage exclusions on your policy because of such a condition. However, if you try to purchase a Medigap policy more than six months after enrolling in Medicare Part B, the companies may refuse to sell you most policies and may deny you coverage for an extended period for your preexisting condition.