AD Banker Comprehensive Practice Exam

A Medicare supplement policy may not limit benefits for losses incurred more than ________ from the effective date of coverage because they involve a preexisting condition.

1. 30 days

2. 1 year

3. 6 months

4. 90 days

The correct answer is: 6 months

A Medicare supplement policy, also known as Medigap, cannot limit benefits for losses incurred more than 6 months from the effective date of coverage that are related to a preexisting condition. This is designed to protect policyholders by ensuring they have access to necessary healthcare services without facing excessive limitations on coverage for conditions that existed before they obtained the policy. This six-month period aligns with the typical standard set by the federal government and various state regulations, ensuring that individuals who may have preexisting health issues are not unfairly denied benefits after their coverage starts. After this duration, insurers may have the right to impose waiting periods on preexisting conditions, depending on the specific terms of the policy. This provision promotes a more equitable insurance environment for consumers who might otherwise be deterred from obtaining essential healthcare coverage due to concerns about their existing health conditions.