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Exam NY-Life-Accident-and-Health Topic 1 Question 28 Discussion

Actual exam question for Insurance Licensing's NY-Life-Accident-and-Health exam
Question #: 28
Topic #: 1
How long can an insurer exclude coverage for a preexisting condition on a Medicare Supplement Policy?

Suggested Answer: A Vote an answer

The correct answer is 6 months . A Medicare Supplement policy , also known as Medigap , may impose a waiting period for coverage of a preexisting condition , but that exclusion period is limited. Under standard Medicare Supplement rules, an insurer may exclude coverage for a preexisting condition for no more than 6 months after the policy's effective date. A preexisting condition generally refers to a condition for which medical advice was given or treatment was recommended or received within a specified period before coverage became effective.
This rule is intended to protect applicants while still allowing insurers limited control over immediate claims related to known medical conditions. In many cases, this exclusion period can also be reduced or eliminated when the applicant has had prior creditable coverage with no significant break in coverage. That is why Medicare Supplement regulations are often tested together with rules about replacement, guaranteed issue, and continuity of coverage.
The other options-12 months, 18 months, and 24 months-are too long for a Medicare Supplement preexisting condition exclusion period. For exam purposes, the maximum exclusion period on a Medigap policy is 6 months , making Choice A correct.

by Lesley at Jul 16, 2026, 10:18 AM

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