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Illinois Medigap OEP

Published by Mike Lovell on

ILLINOIS MEDIGAP OPEN ENROLLMENT PERIOD – NEW LAW

There was a recent bill passed for the state of Illinois that impacts people on Medicare.  It’s Illinois Senate bill 147 – Medicare Open Enrollment

It appears the goal of the bill is to help provide extra flexibility for people that have a Medigap/Medicare supplement policy.

Unfortunately, some companies offer very low teaser premiums to get people in the door.  Then the price increases dramatically until just a few years later people are paying twice as much as when they first enrolled.

SENATE BILL 147  LANGUAGE

 

“Replaces everything after the enacting clause. Amends the Illinois Insurance Code. Provides that, if an individual is at least 65 years of age but no more than 75 years of age and has an existing Medicare supplement policy, the individual is entitled to an annual open enrollment period lasting 45 days, commencing with the individual’s birthday, and the individual may purchase any Medicare supplement policy with the same issuer that offers benefits equal to or lesser than those provided by the previous coverage. Provides that, during this open enrollment period, an issuer of a Medicare supplement policy shall not deny or condition the issuance or effectiveness of Medicare supplemental coverage, nor discriminate in the pricing of coverage, because of health status, claims experience, receipt of health care, or a medical condition of the individual. Requires an issuer to provide notice of this annual open enrollment period for eligible Medicare supplement policyholders at the time that the application is made for a Medicare supplement policy or certificate. Provides that the notice shall be in a form that may be prescribed by the Department of Insurance. Effective January 1, 2022.”

What does this actually mean?

 

This bill does a few key things but people need to fit very specific criteria in order to take advantage of this opportunity.

You must be able to say yes to all of the following:

  • Do you have a Medigap/Medicare supplement now?
  • Are you between the ages of 65 and 75?
  • Are you within 45 days of your birthday?

If you can say yes to those 3 questions then you qualify.

But what do you actually qualify for?

You qualify to change your Medigap/Medicare supplement to a different policy that has equal or lesser benefits than you have now.  But you can only change to a different policy with the same company you have now.

This law becomes effective January 1st.

 

Things to keep in mind:

 

  1. You must have a Medicare supplement in order to be eligible for this guaranteed right to change coverage. So if you have a Medicare Advantage plan, you are NOT eligible for this right under this law.
  2. Your benefits/coverage will be equal or more likely reduced by changing plans.
  3. It’s not that helpful because you have to stay with the same company you have now. So if you chose a small “fly by night” company or one that has a history of large increases after getting you in the door then you will still be a in tough spot.
  4. You can always submit an application for underwriting through different companies. I help people with this every week. The process involves me asking the health questions that insurance company asks.  Depending on how you are able to answer those health questions, you may qualify to change companies.  This gives you MUCH MORE flexibility compared to relying on the specific criteria of the law.

Remember, I am an independent insurance agent that works for you.  NOT an insurance company.  You pay me nothing.  You also don’t pay one penny more for using me. Because I am compensated by whichever insurance company you choose for me to help you enroll with.

To see what options are available for you and how we can tailor coverage for your unique situation:

I’ll talk to you soon!

Medicare Mike Lovell