760 IAC 3-9-1 - Open enrollment

Authority: IC 27-8-13-9; IC 27-8-13-10; IC 27-8-13-10.1

Affected: IC 27-8-13-1

Sec. 1.

(a) No issuer shall:

(1) deny or condition the issuance or effectiveness of any Medicare supplement policy or certificate available for sale in this state; or

(2) discriminate in the pricing of the policy or certificate; because of the health status, claims experience, receipt of health care, or medical condition of an applicant in the case of an application for a policy or certificate that is submitted before or during the six (6) month period beginning with the first day of the first month in which an individual is both at least sixty-five (65) years of age and enrolled for benefits under Medicare Part B. Each Medicare supplement policy and certificate currently available from an insurer shall be made available to all applicants who qualify under this subsection without regard to age.

(b) If an applicant:

(1) qualifies under subsection (a);

(2) submits an application during the time period referenced in subsection (a); and

(3) as of the date of application, has had a continuous period of creditable coverage of at least six (6) months; the issuer shall not exclude benefits based on a preexisting condition.

(c) If an applicant:

(1) qualifies under subsection (a);

(2) submits an application during the time period referenced in subsection (a); and

(3) as of the date of application, has had a continuous period of creditable coverage that is less than six (6) months; the issuer shall reduce the period of any preexisting condition exclusion by the sum of the period of creditable coverage applicable to the applicant as of the enrollment date.

(d) Except as provided in this section, section 2 of this rule, and 760 IAC 3-19-1, subsection (a) shall not be construed as preventing the exclusion of benefits under a policy, during the first six (6) months, based on a preexisting condition for which the policyholder or certificate holder received treatment or was otherwise diagnosed during the six (6) months before the coverage became effective.

Notes

760 IAC 3-9-1

Department of Insurance; 760 IAC 3-9-1; filed Jul 8, 1993, 10:00 a.m.: 16 IR 2573; filed Jul 18, 1996, 1:00 p.m.: 19 IR 3419; filed Feb 1, 1999, 10:45 a.m.: 22 IR 1975; readopted filed Sep 14, 2001, 12:22 p.m.: 25 IR 531; filed Sep 14, 2005, 3:00 p.m.: 29 IR 528; readopted filed Nov 29, 2011, 9:14 a.m.: 20111228-IR-760110553RFA Readopted filed 11/20/2015, 9:25 a.m.: 20151216-IR-760150341RFA Readopted filed 11/15/2021, 8:32 a.m.: 20211215-IR-760210419RFA