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November 30, 2017
Can I still get Medicare Supplement Insurance if I have diabetes?

Can I still get Medicare Supplement Insurance if I have diabetes?

When you have a health condition like diabetes, you might be worried that you won’t be eligible for Medicare Supplement Insurance.

And it’s true – health conditions can be a major issue when you start looking at Medicare Supplements.

However, the fact of the matter is that you can still qualify for a Medicare Supplement even if you have diabetes.

We’ll go through these circumstances to give you a better idea of how diabetes impacts your Medicare Supplement eligibility.

How does diabetes affect my Medicare Supplement eligibility?

When you start filling out an application for a Medicare Supplement (also called Medigap), you’ll notice that there’s a section about your health.

In this health section, there are lots of questions about certain diseases and conditions. In sum, if you have any of these conditions, you’re automatically declined. (Later in this post, we’ll explain the circumstances when you don’t have to answer any health questions.)

For many carriers, diabetes is one of these concerns. However, simply having diabetes doesn’t automatically decline you.

There is usually a set of specific questions that help the insurer decide how risky you are:

  • How much insulin do you take?
  • How many total medications do you take?
  • Do you have any other conditions, such as high blood pressure?
  • How much do you weigh?

All of these questions help the underwriter decide if you’re going to be too expensive to insure. If they find your diabetes to be too risky, they’ll decline you.

So, what are these specific qualifications, and how do you get around them?

In what circumstances would my diabetes cause my application to be declined?

Each carrier is different, which means some carriers are more lenient than others.

But first, you might be wondering: what’s the advantage to being accepted by multiple carriers?

It all comes down to price. When you’re completely healthy, you can price shop each carrier and choose the one with the lowest monthly premium.

If you have a health condition, and only a few carriers will accept you, you have less options. This means you may end up paying a bit more for the insurance.

So, if you were healthy, you might have 20 carriers to choose from. But if you have diabetes, you might only have 3 to choose from. You may still get a great price, but your options are now limited.

Because each carrier is different, we can’t make a blanket statement about when you’d be accepted and when you’d be declined. However, here are some things to consider.

Do you take insulin?

While some carriers automatically decline you if you take insulin at all, many will still accept you.

However, they do have a limit on how much insulin they’ll accept.

For example, some carriers have a 50 unit limit. If you take more than 50 units of insulin per day, you’ll be declined. There is one carrier who accepts up to 60 units, but if you take more than that, most carriers will decline your application.

How many total medications do you take?

Along with the insulin limit, many carriers also have a limit on how many medications you take.

For example, some will decline you if you take more than 2 total medications, while others allow up to 3.

Do you have any other conditions, such as high blood pressure?

Almost every Medicare Supplement carrier is concerned about diabetes in combination with another condition. For example, a lot of carriers will not accept your application if you have diabetes and a vascular disease.

Other examples would be diabetes with high blood pressure, diabetes with neuropathy, or diabetes with retinopathy.

On the bright side, some carriers will still accept the application, but they’ll screen you a bit closer. Some even say they may accept you, but you’ll receive a higher rate. While this isn’t ideal, it’s better than being declined.

How much do you weigh?

Almost all Medicare Supplements require you to adhere to a weight chart. That means that even if you’re totally healthy, you can’t weigh more than the maximum weight.

However, when you have diabetes, some insurance carriers have a weight chart specifically for you. This weight chart is actually more strict than the normal weight chart.

Other carriers have a special stipulation that you can’t be more than, for example, 50 pounds overweight.

Can I get a Medicare Supplement without having to pass underwriting requirements?

If you’ve gotten to this point and have realized you wouldn’t be able to pass any underwriting, all is not lost!

There are 2 special circumstances where you don’t have to answer any health questions at all. These are called open enrollment and Guaranteed Issue (GI).

Open enrollment is when you’ve signed up for Medicare Part B for the first time. In this situation, you don’t have to answer any health questions.

Guaranteed Issue (GI) is a little bit more complicated, but here are a couple common examples:

  • You’re in a Medicare Advantage Plan, and you move out of the plan’s service area.
  • Your employer’s group health plan is ending.

So, if you qualify for open enrollment or Guaranteed Issue (or both at the same time), you don’t have to pass medical underwriting at all.

If you’re getting a bit of a headache and would rather have someone else figure this out for you, please contact us!

Our agents are experts and know the rules inside and out. With us, you’re never alone.

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