Reminder!
This is a reminder regarding California Insurance Code 10192.12, Section (D)(i), which defines guaranteed issue rights when a Medicare Advantage plan undergoes In Texas, HB 2516 took effect on September 1, 2025, expanding eligibility for Medicare Supplement plans to individuals under age 65 who have been medically diagnosed with End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS). The regulation also established a special one-time Open Enrollment (OE) period for those who were previously eligible before the effective date. This OE period begins on December 1, 2025. Please see below for additional details.
Special One-Time Open Enrollment Period
- Eligibility: Individuals diagnosed with ESRD or ALS prior to Sept 1, 2025
- Enrollment Window: Dec 1, 2025 – June 1, 2026
- Plans: All plans available
- Compensation: GI Compensation will be paid
- Individuals under age 65 applying for Medicare supplement plans due to a diagnosis of ESRD or ALS must submit proof of diagnosis with their application. Examples of acceptable documentation include:
- Medicare benefit award letter listing ESRD or ALS
- Letter or statement from a licensed physician (M.D. or D.O.) confirming diagnosis
Updated Resources:
The Underwriting Guidelines have been updated and are available in Market on Demand, SPA, and Forms and Materials.
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