Starting July 1, 2023, Rhode Island has implemented changes for those eligible for Medigap Under 65. Read all about the new rules below. If you are under 65 looking for Medigap in any other state than Rhode Island check out our complete Medigap Rules for Under65 article.
Medigap Changes for Under 65 in RI
The Rhode Island Office of the Health Insurance Commissioner (OHIC) is making changes starting July 1, 2023. Per RIGL 27-18.2-3(g), Med Supp carriers must offer Medigap Plan A to those under 65 eligible due to disability or ESRD.
This applies if the applicant submits their application during the initial six (6) months following eligibility for Medicare Part B. Read all about Medigap Under 65 rules in this article on Senior65.com.
When can Rhode Islanders under 65 enroll in Medigap coverage?
Individuals under 65 can enroll in Medigap during an alternate enrollment period, starting July 1, 2023. This “open enrollment period” applies to those eligible for Medicare due to disability or ESRD per the amended legislation. This open enrollment period spans sixty (60) calendar days and ends on Wednesday, August 30, 2023.
During the sixty-day open enrollment period, Medigap carriers cannot base policy issuance on an applicant’s medical or health status. Insurers are prohibited from conducting individual medical underwriting on any applicant.
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Why were these changes implemented?
These changes were introduced to cater to the specific requirements of individuals under the age of 65 who have End-Stage Renal Disease (ESRD). The majority of ESRD patients qualify for Medicare irrespective of their age and opt to enroll in the program as their primary health insurance. However, many of these patients need supplementary private Medigap insurance to cover their deductibles and copayments because Medicare Part B only covers 80 percent of healthcare costs without a cap on out-of-pocket expenses.
Patients with ESRD face intricate healthcare demands and encounter substantial out-of-pocket expenses, averaging over $10,000 annually for end-stage renal disease. These modifications aim to enhance their access to Medigap coverage, thereby alleviating the financial strain associated with their healthcare bills.
“Nearly 50 percent of dialysis patients in Rhode Island are under 65 and without a Medicare Supplement plan many patients are ineligible for a transplant because they are considered ‘under-insured.’ Since a kidney transplant is the best treatment for those with end-stage renal disease, this legislation could be a lifesaver,” said Rep. Brian Patrick Kennedy (Source).
Next Step
If you meet RI’s new rules, contact us at 800-930-7956 for assistance from licensed agents. There is never a charge or hidden fee to work with us and no one can sell the same Med Supp plan for less than Senior65.com can.