FAQ Friday: Do I Have To Medically Qualify For Medicare

You do not have to medically qualify for Original Medicare. Everyone who is 65 or older is entitled to Medicare Parts A and B without having to medically qualify. If you are under 65 and have been on disability for two years or more, you are also eligible for Medicare.

In order to purchase a Medicare Advantage Plan, there is only one medical question that you must answer to qualify which is “Do you have End Stage Renal Disease (ESRD)?” If you do have ESRD do not be discouraged; there are special plans that Medicare offers to seniors who have ESRD, however you will not have access to the open market Medicare Advantage Plans available to others.

As far as a Medicare Supplement (Medigap), everyone has the opportunity to get a Medicare Supplement when they first turn 65, or when they first start Medicare Part B, without having to medically qualify. This is called your Open Enrollment Period and it begins 6 months before and ends 6 months after your 65th birthday or your Medicare Part B start date. After that timeframe, everyone is subject to medical underwriting. The Medicare Supplement medical underwriting only consists of around 20 medical questions, there is no physical or lab work. There are around 30 different carriers that offer Medicare Supplements and they all have different guidelines. In general, most carriers want at least a two-year stable bill of health.

If you have any questions regarding Medicare, please give our office a call at 1-855-368-4717 or visit one of our pages:

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