Can You Be Denied Medicare? - Trusted Senior Specialists

In order to be eligible for Medicare, you must meet a few specific criteria. People who are above age 65 and U.S. citizens or legal residents are eligible to apply for Medicare. If you’re under 65, you may qualify for Medicare based on a disability and will need to have a specific diagnosis that’s been approved by Medicare. In order to qualify via a disability, you must collect Social Security Disability Insurance for at least 24 months. At that point, you can contact Medicare for enrollment or you may be automatically enrolled depending on your tax payment status. 

Enrollment Is Specific

Medicare is extremely specific. The times when you can enroll, make changes to your plan or switch to another policy are very strict. Adhering to Medicare’s policies can be complicated, so you may be wondering if it’s possible for you to be denied by Medicare.

When beginning this discussion, it’s important to mention premiums. Premiums are the price paid each month to keep your Medicare insurance. Those who have paid the needed taxes will receive Part A premium-free. If you haven’t paid the necessary taxes, then you may be able to purchase Part A and will need to pay the premiums.  In this sense, it is entirely possible for you to be denied premium-free Part A, but you will most likely be able to pay for it and get the same coverage you would otherwise.

What About Medicare Advantage?

Medicare Advantage plans are sold through private insurance companies. They must include the coverage that Original Medicare does, but allow the beneficiary to select other areas of coverage they would like to be included in their policy. It’s possible for a Medicare Advantage plan to deny someone.  

If the individual has a severe health problem, such as end-stage renal disease, then they can be denied the majority of Medicare Advantage plans. They’ll most likely only be eligible to enroll in a Special Needs policy. This type of policy will provide coverage unique to their diagnosis and is an option that can grant access to specialized treatments and therapies.

Could You Be Denied?

In most places, it’s possible to be denied Medicare due to a pre-existing condition. If you’ve been denied, consult an insurance agent to see if there is anything you can do to still gain access to Medicare. Medicare’s rules and regulations are changed frequently, so make sure you stay updated and aware of their policies.

Call Our Agency If You’ve Been Denied

If you’ve been denied Medicare, give us a call today. Our professionals are at the top of their field and know the details that Medicare requires. We’re here when you need us.