Indiana Code 27-8-13-9.2. Limitations on issuer of medicare supplement policies when the applicant has certain disabilities or has end stage renal disease
(1) who is less than sixty-five (65) years of age;
Terms Used In Indiana Code 27-8-13-9.2
- applicant: means :
Indiana Code 27-8-13-5
- certificate: means a certificate:
Indiana Code 27-8-13-6
- issuer: includes :
Indiana Code 27-8-13-7.3
- medicare: means Title XVIII of the federal Social Security Act (Indiana Code 27-8-13-1
- Medicare supplement policy: means a group or individual policy of accident and sickness insurance or a subscriber contract of health maintenance organizations that is advertised, marketed, or designed primarily as a supplement to reimbursements under Medicare for the hospital, medical, or surgical expenses of persons eligible for Medicare benefits. See Indiana Code 27-8-13-3
- Month: means a calendar month, unless otherwise expressed. See Indiana Code 1-1-4-5
(A) by reason of a disability as described in 42 U.S.C. § 426(b) and defined in 42 U.S.C. § 423(d); or
(B) by reason of being medically determined to have end stage renal disease as described in 42 U.S.C. §§ 426-1; and
(3) who applies for a Medicare supplement policy or certificate and either:
(A) submits the application before or during the six (6) month period beginning with the first day of the first month during which the applicant becomes enrolled for benefits under Medicare Part B without regard to age; or
(B) was enrolled for benefits under Medicare Part B without regard to age before January 1, 2025, and:
(i) submits the application for a Medicare supplement policy or certificate during the six (6) month period beginning January 1, 2025; or
(ii) is unable to submit an application for a Medicare supplement policy or certificate because an application is not yet available but makes a request for an application for a Medicare supplement policy or certificate during the six (6) month period beginning January 1, 2025.
(b) After December 31, 2024, the issuer of a Medicare supplement policy or certificate shall not:
(1) deny or condition the issuance or effectiveness of a Medicare supplement policy or certificate to which subsection (a)(3) applies because of the health status, claims experience, receipt of health care, or medical condition of an individual described in subsection (a);
(2) charge an individual described in subsection (a) a premium rate for a standardized Plan A, Plan B, or Plan D Medicare supplement policy or certificate to which subsection (a)(3) applies that exceeds the premium rate the issuer charges an individual who is sixty-five (65) years of age for the same Medicare supplement policy or certificate;
(3) charge an individual described in subsection (a) a premium rate for any standardized lettered Medicare supplement policy or certificate other than those specified in subdivision (2) to which subsection (a)(3) applies that exceeds two hundred percent (200%) of the premium rate the issuer charges an individual who is sixty-five (65) years of age for the same Medicare supplement policy or certificate; or
(4) issue to an individual described in subsection (a) a Medicare supplement policy or certificate to which subsection (a)(3) applies that contains:
(A) a waiting period; or
(B) a preexisting condition limitation or exclusion.
As added by P.L.28-2024, SEC.3.