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Can I be denied Medigap for pre-existing conditions?

Inside your open enrollment window, no. Outside it in Texas, yes. Here is what underwriting actually looks at.

Updated August 17, 2026 · 2 min read

The answer depends entirely on timing, and this is the place where Medicare's rules are least forgiving.

Inside your six month window: no

During your Medigap open enrollment, which runs six months from when your Part B begins at or after 65, no company in Texas can decline you or charge you more because of your health.

If you had at least six months of prior creditable coverage, they also cannot impose a waiting period for a pre-existing condition. Without prior coverage, a waiting period of up to six months is possible for conditions treated or diagnosed in the six months before your policy starts.

Outside the window: yes

Texas allows medical underwriting on Medigap policies outside guaranteed issue situations. That means an application with health questions, and the company can decline you, charge more, or exclude a condition.

What underwriting looks at

It varies by company, which is why an agent representing several carriers is useful here. Common areas of focus:

• Recent hospitalizations or surgeries, and any scheduled ones
• Ongoing treatment for cancer, heart, lung or kidney conditions
• Insulin use and diabetes complications
• Oxygen use
• Certain neurological conditions
• The medications you take, which often reveal more than the questions do

Companies differ meaningfully in what they will accept. One carrier's decline is another carrier's approval, and that is not a small point.

The guaranteed issue situations

Outside your window, certain circumstances still give you the right to buy without underwriting.

• Your Advantage plan leaves your area or loses its contract
• You move out of your plan's service area
• Trial right: you joined Advantage when first eligible at 65 and leave within twelve months
• Trial right: you dropped a Medigap policy to try Advantage and return within twelve months
• Employer or union coverage ending, in certain cases
• The company misled you or went out of business

These are time limited, typically 63 days from the event. See moving from Advantage to a supplement.

If you cannot pass underwriting

You are not out of options, they are just different ones.

• Apply with a different carrier. Standards vary significantly.
• Consider a plan letter with lighter underwriting at some companies, or a high deductible version. See high deductible Plan G.
• Choose a Medicare Advantage plan with a low out of pocket maximum and a broad network, since Advantage plans cannot decline you.
• If you qualify for Medicaid or a savings program, look at a dual eligible plan. See D-SNP plans.

Apply and get an approval in hand before dropping anything you currently have. Never cancel first.