Treatment of Pre-Existing Conditions Under Medicare Supplement Policies

Under a Medicare Supplement policy, a pre-existing condition is a medical condition for which medical advice was given or treatment was recommended by or received from a physician within six months prior to the effective date of coverage.

A Medicare Supplement policy cannot use riders or endorsements to exclude, limit, or reduce coverage or benefits for specifically named or described pre-existing diseases or physical conditions.

If a Medicare Supplement policy replaces another Medicare Supplement policy, the replacing insurer must waive any time periods applicable to pre-existing conditions including:

  • Waiting periods

  • Elimination periods

  • Probationary periods in the new Medicare Supplement policy for similar benefits to the extent such time was spent under the original policy