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Medicare Laws for Medigap

Medicare Supplement Insurance is federally regulated but there are also state laws that these carriers must follow.  A Federal law that is in place is the Open Enrollment Period and Guaranteed Issue rights.  State are required to follow these guidelines but can add layers to them as they please. Below Medicare Insurance Finders will give you a simple example:

  • Mississippi. In the wonderful State of Mississippi anyone under 65 has a guaranteed issue period for 65 after receiving Medicare Part B.  This is not a requirement for all states but Mississippi has added this layer to their state laws for Medigap plans.

Texas Medicare Supplemental Insurance

  • Medicare Due to Disability: Plan A must be provided by each Medicare Supplement Carrier in the state of Texas for Under Age 65 Medicare Beneficiaries (those on Medicare Due to Disability).  Also this coverage is Guaranteed Issue if applying within six months of Part B
  • Premium Rate Ups: In the state of TX premium rate ups do not apply.  Ex: Height and weight rate ups cannot be issued by a Medigap plan (however they can be declined).
  • State Special Form: Definition off Eligible Person for Guaranteed Issue Notice – this must be provided to client
  • Gender Rates – there are no Gender rates for Texas Medicare Supplements.
  • Guaranteed Issue Rights for Loss of Medicaid – Medigap Plan A, B, C, F, K, or L offered by an issuer;

Mississippi Medicare Supplemental Insurance

  • Under Age 65 State Requirement: All plans available and coverage is guaranteed issue if applied for within six months of Part B enrollment.

California Medicare Supplemental Insurance

  • Under Age 65 State Requirement: Plans A & F available.  Coverage is Guaranteed Issue if applied for within six months of Part Be Enrollment.  Not available for individuals with end stage renal disease.
  • GI Rights for Loss of Medicaid: Age 65+ any Medigap plan offered by an issuer; Under age 65 only A&F
  • Collection of Premium: In California, only one month’s premium can be submitted with the application.
  • State Special Forms: California Agent/Applicant Meeting Form and Guaranteed Issue and Open Enrollment Notice for California
  • Gender Rates: No gender rates for California Medicare Supplements
  • Sunshine Law : Individuals have a guaranteed issue time period each year on their birthday

Florida Medicare Supplemental Insurance

  • Under Age 65 State Requirements: All Plans in Open Enrollment and only A, B, C, or F offered in Guaranteed Issue time periods.

New York Supplemental Insurance

  • New York State Law and regulation require that any insurer writing Medigap insurance must accept a Medicare enrollee’s application for coverage at any time throughout the year.  Insurers may not deny the applicant a Medigap policy or make any premium rate distinctions due to health status, claims experience, medical condition or whether the applicant is receiving health care services.
These are laws to know and understand if you are residing in one of these five states and are looking for Medicare Supplement Insurance.  Please give us a call at 1-877-936-2991 if we you need help with your Medigap plan.

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