State Rules for Those purchasing Medigap Under Age 65 (Medicare Due to Disability)

  • Federal Government has NO REQUIREMENTS which force Medicare Supplement Companies to Issue Policies to those Under age 65.

  • Therefore, some states have added requirements to allow those under 65 on Medicare to purchase a Medigap Policy.

State Underwritten Open Enrollment Guarantee Issue
Alabama No Requirements No Requirements No Requirements
Alaska No Requirements No Requirements No Requirements
Arizona No Requirements No Requirements No Requirements
Arkansas No Requirements No Requirements No Requirements
California (1) Disabled Individuals are covered by California's "equal or lesser than" rules Disabled Individuals are covered by California's "equal or lesser than" rules Disabled Individuals are covered by California's "equal or lesser than" rules
Colorado No Requirements All Plans A, B, C or F
Connecticut No Requirements A and B are always Guarantee Issue A and B are always Guarantee Issue
Delaware No Requirements Yes, New Reg adopted 1/16/09.  See Note (2), below. Unknown if 1/16/09 Reg. applies to GI plans.
District of Columbia No Requirements No Requirements No Requirements

Florida

 

No Requirements All Plans A, B, C or F
Georgia No Requirements No Requirements No Requirements
Hawaii Unknown Unknown Unknown
Idaho No Requirements No Requirements No Requirements
Illinois No Requirements All Plans (Including those notified retroactively of eligibility).  Full Commission. A, B, C or F (Full Commission)
Indiana No Requirements No Requirements No Requirements
Iowa No Requirements No Requirements No Requirements
Kansas No Requirements All Plans A, B, C or F
Kentucky Plan A is always GI. Plan A is always GI. Plan A is always GI.
Louisana No Requirements All Plans A, B, C or F
Maine Maine's Continuity of Coverage Regulation applies, See Note 3, below. Maine's Continuity of Coverage Regulation applies, See Note 3, below. Maine's Continuity of Coverage Regulation applies, See Note 3, below.
Maryland No Requirements Plans A, C Plans A, C
Massachusetts Unknown Unknown Unknown
Michigan No Requirements No Requirements No Requirements
Minnesota No Requirements Basic and Ext Basic with Optional Riders Basic and Ext Basic with Optional Riders
Mississippi No Requirements All Plans A, B, C or F
Missouri Missouri has a "Like for Like" regulation, see Note 4, below. All Plans A, B, C or F
Montana No Requirements No Requirements No Requirements
Nebraska No Requirements No Requirements No Requirements
Nevada No Requirements No Requirements No Requirements
New Hampshire No Requirements All Plans A, B, C or F
New Jersey No Requirements Plan C (Age 50-64 only) Plan C (Age 50-64 only)
New York Unknown Unknown Unknown
New Mexico No Requirements No Requirements No Requirements
North Carolina No Requirements Plans A and C Plans A and C
North Dakota No Requirements No Requirements No Requirements
Ohio No Requirements No Requirements No Requirements
Oklahoma No Requirements Plan A Plan A
Oregon No Requirements All Plans A, B, C and F
Pennsylvania No Requirements All Plans A, B, C and F
Rhode Island No Requirements No Requirements No Requirements
South Caronlina No Requirements No Requirements No Requirements
South Dakota No Requirements All Plans A, B, C and F
Tennessee No Requirements All Plans A, C, and F
Texas No Requirements Plan A Plan A
Utah No Requirements No Requirements No Requirements
Vermont No Requirements All Plans A, B, C and F
Virginia No Requirements No Requirements No Requirements
Washington Unknown Unknown Unknown
West Virginia No Requirements No Requirements No Requirements
Wisconsin No Requirements Basic Plan with Optional Riders Basic Plan with Optional Riders
Wyoming No Requirements No Requirements No Requirements

1.  California Birthday Regulation

 

2.  Delaware enacted a new regulation on 1/16/2009 requires Special Rates for Disabled and Special Rates for End State Renal Disease.  For 6 months following enrollment in Part B, these populations would be considered Open Enrollment.  In addition, those individuals already enrolled in Medicare Part B (due to Disability or ESRD) will be in Open Enrollment until June 12, 2009.

 

3.  For Maine, there is a Continuity of Coverage provision that allows eligible applicants to be issued policies without underwriting if they had been covered under a policy that supplemented benefits under Medicare with no gap in coverage greater than 90 days beginning with the personís open enrollment period. The applicant must indicate in writing that he/she originally enrolled for a Medicare Supplement policy during an open enrollment period and that they have never had more than a 90-day gap in coverage. Any plan available for open enrollment and underwriting (over and under age 65) will be made available for those applying under Maine Continuity of Coverage.

 

4.  In Missouri, a Medicare beneficiary who terminates coverage within 30 days of his/her annual policy anniversary date is eligible for a Guaranteed Issue policy of the same (like-for-like) plan.  The applicant must provide proof of the previous coverage.