Can You Be Denied a Medicare Advantage Plan?

Question

Lori Marion` · Accepted Answer

As long as you apply for a plan during a valid election period and you meet the eligibility requirements, you can't be denied. 
To qualify for a Medicare Advantage plan,  you must have both part A and part B of Medicare. Some plans have additional requirements such as plans designed for people who have a chronic condition such as diabetes or heart conditions. There are also plans designed specifically for people who also have Medicaid and may contain additional requirements that look into the level of Medicaid or state wavers. It's always best to work with an experienced agent to help guide you through the process of choosing and enrolling into a plan.

Michael Andrews · Answer

So the question is, can you be denied a Medicare Advantage plan? I'm assuming this question is asking, can you be denied from enrolling into a Medicare Advantage plan? The short answer to that is no. However, you do need to qualify.

Most Medicare Advantage plans are available to anybody that is eligible for Medicare. However, there are certain plans, such as Dual Special Needs Plans, that are typically for people that have a lower income and are on Medicare. There are also plans known as Chronic Special Needs Plans for individuals that have specific chronic health conditions.

All those plans vary depending on where you live, depending on the state you live in, and even down to the zip code of the house.

Pauline Weiland · Answer

Assuming you have Medicare Part A and Part B, an Advantage plan cannot discriminate for any reason. You are not automatically eligible for all Advantage plans. Some plans require you have your state Medicaid or a Doctor verification form of certain kinds of chronic conditions. Also if you have a State drug plan or VA, you can get the Advantage coverage with no Rx included. It's helpful to speak to a local agent representing multiple companies to best know your situation.

Answered by Pauline Weiland on April 13, 2026

Agent Licensed in AZ, CA, MS, NV & TX

Answered by Pauline Weiland Medicare Insurance Agent

Ashley King · Answer

Enrollment in a Medicare Advantage Plan may be denied if the beneficiary does not live in the plan service area, don't have both Parts A and B, or don't meet Medicaid level requirements for certain plans.

Answered by Ashley King on April 13, 2026

Broker Licensed in MD, AL, AR & 9 other states

Answered by Ashley King Medicare Insurance Agent

Charles Calvin · Answer

You cannot be denied a Medicare Advantage plan based on your health. However, you do have to have a valid enrollment/election period to be able to enroll, as well as having both Parts A & B of Medicare.

Answered by Charles Calvin on April 13, 2026

Broker Licensed in MO, FL, IA, IL, KY & SC

Answered by Charles Calvin Medicare Insurance Agent

Brooke Smith · Answer

Medicare Advantage Plans do not deny applicants due to pre-existing conditions. As long as you live within the plan's service area and you are enrolled in Orginal Medicare Parts A and B, you shouldn't run into any problems.

Answered by Brooke Smith on April 13, 2026

Agent Licensed in UT, CA, ID, NV, OR & WY

Answered by Brooke Smith Medicare Insurance Agent

Edward MacConnell · Answer

Yes you can be denied a Medicare Advantage plan if you do not have a valid election period or you do not live in the advantage plans geographic area.

Destin Marks · Answer

As long as you qualify or currently receive medicare part a and b as well as have a special enrollment period you can not be denied for any any health conditions to be approved for coverage.