Doctor’s Diary October 3, 2017: Age as a pre-existing condition

(Snippets from the frontline)

Age as a pre-existing condition

When one reaches 65 years old, there is an option to apply for supplemental insurance known as a “secondary” to cover costs not payed for by Medicare.  Several years ago I filled out the application checklist, and because I was healthy, received my choice of secondary Medicare insurance.

A friend though applied, and was denied because he checked off a condition known as COPD. 

Why does the Affordable Care Act (Obamacare) eliminate “pre-existing condition”, yet Medicare insurance companies can still deny seniors a supplemental health plan?

Do seniors have to pay higher premiums, or be forced into a plan they don’t want (like HMO)?  What if you want to change your secondary plan at age 85?  Certainly by then you will have some kind of illness that might be called “pre-existing.”

Age discrimination.

Gene Uzawa Dorio, M.D.

1 Comment

  • Federal rules on preexisting condition provisions in covered individual and group health plans and health insurance don’t apply to “excepted benefits.” The Health Insurance Portability & Accountability Act (HIPAA)limitation of allowable period to a maximum of 18 months reduced by prior periods of creditable coverage and the subsequently enacted Patient Protection and Affordable Care Act (ACA) blanket prohibition against preexisting condition limitations in group and individual health plans don’t apply to “exempted benefits.”

    Both HIPAA and the ACA use the same rules to determine when an arrangement qualifies as an “exempted benefit” not required to comply with their preexisting condition and certain other health plan mandates. Regulations implementing these rules recognize “Medicare supplement” and certain other supplemental coverage as covered by these exemptions.
    See, e.g.

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