Can Medicare Advantage plans deny coverage for pre-existing conditions?

Answered by 9 licensed agents

Medicare Advantage plans generally cannot deny enrollment or coverage because of pre-existing conditions. As long as you're eligible for Medicare and enroll during a valid enrollment period, the plan must accept you, with only a few limited exceptions such as End-Stage Renal Disease rules that have largely been eliminated in recent years.

Answered by John Dalziel on July 27, 2026

Broker Licensed in OH, FL, IA & 7 other states

Answered by John Dalziel Medicare Insurance Agent
No Medicare Advantage plans will not deny coverage for pre-existing conditions. There are certain Medicare advantage plans called CSNP plans Chronic Special needs plans where you have to have a pre existing condition to join these plans. Medicare Supplement plans can deny for the pre existing conditions though.

Answered by Collin McCoy on July 27, 2026

Broker Licensed in PA, LA, MD, TN & VA

Answered by Collin McCoy Medicare Insurance Agent
No, Medicare Advantage plans cannot deny your enrollment nor limit your coverage based on preexisting conditions. By law, private insurance companies must accept any application as long as the person is eligible and has a valid enrollment period.

Answered by Pamela Masters on July 27, 2026

Broker Licensed in NC

Answered by Pamela Masters Medicare Insurance Agent
No, Medicare Advantage plans can't deny you enrollment or refuse to cover pre-existing conditions. potentially, they may require prior authorization for specific treatments and restrict care to in-network providers

Answered by Fawn Alfaro on July 27, 2026

Broker Licensed in OR, AK, AZ & 5 other states

Answered by Fawn Alfaro Medicare Insurance Agent
Medicare Advantage plans can not deny you coverage for pre-existing conditions. They must accept all eligible Medicare beneficiaries for enrollment.

Answered by Elleanor Saylor on July 27, 2026

Agent Licensed in SC, AL, AR & 45 other states

Answered by Elleanor Saylor Medicare Insurance Agent
No, Medicare3 advantage plans cannot deny coverage for pre-existing conditions. They can though require preauthorization.

Answered by Grant Chapman on July 27, 2026

Broker Licensed in FL, AL, AR & 29 other states

Answered by Grant Chapman Medicare Insurance Agent
Absolutely not, and sales agents are prohibited from asking most medical history questions. Agents restricted to asking questions necessary to determine if the person has a Special Need

Answered by Donald Elliott on July 27, 2026

Broker Licensed in AL, GA & MS

Answered by Donald Elliott Medicare Insurance Agent
No, Medicare Advantage plans cannot deny coverage for pre-existing conditions, as long as the coverage is a Medicare eligible expense.

Answered by Matthew Feir on July 27, 2026

Agent Licensed in ND, MN & SD

Answered by Matthew Feir Medicare Insurance Agent
No, Medicare Advantage plans cannot deny you enrollment or refuse to cover pre-existing conditions.

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Answered by Randy Yates on July 27, 2026

Broker Licensed in WA, AZ, CA & 10 other states

Answered by Randy Yates Medicare Insurance Agent

Tags: Coverage Eligibility Medicare Advantage

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