Congratulations on reaching Medicare eligibility! Your coverage with Medicare is very comprehensive. When you become Medicare eligible, Medicare covers all your pre-existing medical conditions with very few exceptions. If you have Diabetes, Cancer, High Blood Pressure or any medical condition, Medicare will cover you starting your first day of eligibility.

Medicare always starts the first of the month, usually the month of your 65 birthday. There are ALWAYS exceptions with Medicare, but that is when most individuals become eligible. If your birthday is the first of the month, your eligibility begins the first of the month before your birthday.

If you are younger than 65 and are now eligible for Medicare for any reason, your medical coverage is the same. There are very few pre-existing condition limitations for Medicare coverage.

When starting Medicare, you will have all the same doctors and hospitals that you have seen, for all those conditions. You will just start with a new payer for those medical bills.

The two exceptions to Medicare related to coverage of those pre-existing conditions are an open workman’s comp claim, and an open automobile insurance claim. When I said open, I mean these two payers are still paying on this previous claim. Sometimes these types of claims are open for a lifetime, but sometimes they max out in payment and then close. Once these types of claims are closed Medicare will need to be notified and then Medicare will pay as primary on those conditions.

There are a few situations where you might run into an initial denial but that is because Medicare simply needs more information from the provider to pay the claim.

There are some limitations with other insurance products related to Medicare. If you stay in original Medicare (Part A and B) then sign up for a Medicare Supplement plan (Medigap) within a short period of time (63 days) of Medicare eligibility, the Medicare Supplement Plan will also have no exclusions in coverage. If you stay with original Medicare and choose not to enroll in a supplemental plan or an alternative within 63 days, then most Medicare Supplement Insurance companies include a six month pre-existing clause. Here is a timeline: If you receive Medicare March 1, 2021 and enroll in a Medicare Supplement to begin by May 1, 2021, you will have no exclusions. If you begin Medicare March 1, 2021 and then don’t choose an additional Medicare Supplement Plan until December 1, 2021, you will have full Medicare coverage, but your Medicare Supplement may have a six-month pre-existing exclusion. I use the word “may” because some companies have a six-month pre-existing exclusion, some have two months. If you delayed getting additional insurance when you first started Medicare, you may want to look into those Medigap plans with a shorter pre-existing exclusion clause, as this could save you a significant amount of money.

If you become Medicare eligible and you decide to enroll in a Medicare Advantage Plan, there may be reasons you are not allowed to join. This is usually tied to the Medicare Part D benefit rules.

When you become eligible for Medicare Part A & B you also must sign up for a Medicare Part D plan. If you don’t do that at the same time there are rules which prevent you from starting that Part D coverage anytime you want.

All of these rules are true for all individuals becoming eligible for Medicare. This includes those who are younger and getting Medicare due to a disability or medical condition. Many people believe that some Medicare rules only apply to those 65 and older and that those who are eligible due to a disability or medical condition have a different set of rules and that is not true. Once you are eligible for Medicare, the enrollment rules are basically the same for everyone.

Congratulations on reaching Medicare eligibility! Your coverage with Medicare is very comprehensive. When you become Medicare eligible, Medicare covers all your pre-existing medical conditions with very few exceptions. If you have Diabetes, Cancer, High Blood Pressure or any medical condition, Medicare will cover you starting your first day of eligibility.

Medicare always starts the first of the month, usually the month of your 65 birthday. There are ALWAYS exceptions with Medicare, but that is when most individuals become eligible. If your birthday is the first of the month, your eligibility begins the first of the month before your birthday.

If you are younger than 65 and are now eligible for Medicare for any reason, your medical coverage is the same. There are very few pre-existing condition limitations for Medicare coverage.

When starting Medicare, you will have all the same doctors and hospitals that you have seen, for all those conditions. You will just start with a new payer for those medical bills.

The two exceptions to Medicare related to coverage of those pre-existing conditions are an open workman’s comp claim, and an open automobile insurance claim. When I said open, I mean these two payers are still paying on this previous claim. Sometimes these types of claims are open for a lifetime, but sometimes they max out in payment and then close. Once these types of claims are closed Medicare will need to be notified and then Medicare will pay as primary on those conditions.

There are a few situations where you might run into an initial denial but that is because Medicare simply needs more information from the provider to pay the claim.

There are some limitations with other insurance products related to Medicare. If you stay in original Medicare (Part A and B) then sign up for a Medicare Supplement plan (Medigap) within a short period of time (63 days) of Medicare eligibility, the Medicare Supplement Plan will also have no exclusions in coverage. If you stay with original Medicare and choose not to enroll in a supplemental plan or an alternative within 63 days, then most Medicare Supplement Insurance companies include a six month pre-existing clause. Here is a timeline: If you receive Medicare March 1, 2021 and enroll in a Medicare Supplement to begin by May 1, 2021, you will have no exclusions. If you begin Medicare March 1, 2021 and then don’t choose an additional Medicare Supplement Plan until December 1, 2021, you will have full Medicare coverage, but your Medicare Supplement may have a six-month pre-existing exclusion. I use the word “may” because some companies have a six-month pre-existing exclusion, some have two months. If you delayed getting additional insurance when you first started Medicare, you may want to look into those Medigap plans with a shorter pre-existing exclusion clause, as this could save you a significant amount of money.

If you become Medicare eligible and you decide to enroll in a Medicare Advantage Plan, there may be reasons you are not allowed to join. This is usually tied to the Medicare Part D benefit rules.

When you become eligible for Medicare Part A & B you also must sign up for a Medicare Part D plan. If you don’t do that at the same time there are rules which prevent you from starting that Part D coverage anytime you want.

All of these rules are true for all individuals becoming eligible for Medicare. This includes those who are younger and getting Medicare due to a disability or medical condition. Many people believe that some Medicare rules only apply to those 65 and older and that those who are eligible due to a disability or medical condition have a different set of rules and that is not true. Once you are eligible for Medicare, the enrollment rules are basically the same for everyone.