A bill to amend title XVIII of the Social Security Act to provide annual and other opportunities for individuals enrolled under a Medicare Select policy to change to a Medigap policy without prejudice

4 Pages·1997·0.16 MB·English

by  United States. Congress. House

PROPERTYOF
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105thcongress H. R. 566
1stSession
To amend title XVTII of the Social Security Act to pro\'ide annual and
otheropportunitiesforindividualsenrolledunderaMedicareselectpolicy
tochangetoamedigappolicywithoutprejudice.
IN THE HOUSE OF REPRESENTATR^S
February4,1997
Mr.Bentsen(forhimself,Mr.Cardin,Mr.Evans,Mr.Frost,Mr.Greek,
Ms. Slaughter, Mr. SmTH of New Jersey, Mr. Stark, and Mrs.
TirURlvlAN)introducedthefollowingbill;whichwasreferredtotheCom-
mitteeonCommerce
A
BILL
To amend title XVTII ofthe Social SecurityAct to pro\'ide
annual and other opportunities for individuals enrolled
under a Medicare select pohcy to change to a medigap
poUcywithoutprejudice.
1 BeitenactedbytheSenateandHouseofRepresenta-
2 tivesoftheUnitedStatesofAmericainCongressassembled,
3 SECTION1.SHORTTITLE.
4 This Act maybe cited as the "Medigap Protection
5 Actof1997".
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1 SEC. 2. CONTINUED ACCESS TO MEDIGAP POLICIES BY
2 MEDICARE-SELECTENROLLEES.
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3 (a)InGeneral. Section 1882(s) ofthe Social Se-
4 curityAct(42U.S.C. 1395ss(s))isamended
5 (1) in paragraph (3), by striking "paragraphs
6 (1) and (2)" and inserting "paragraphs (1), (2), or
7 (3)",
8 (2) by redesignating paragraph (3) as para-
9 graph(4),and
10 (3) byinsertingafterparagraph (2) the follow-
11 ingnewparagraph:
12 "(3)(A)TheissuerofaMedicaresupplementalpoUey
13 shall provide enrollment periods described in subpara-
14 graph (B) duringwhich an indi\idual described in sub-
15 paragraph (C) mayelect coverageunder anysuch Medi-
16 care supplemental policyofsuchissuer as a replacement
17 fortheMedicareselectpolicy.Theelectionofsuchapolicy
18 shallbecomeeffectiveinatimelymanner (asspecifiedby
19 theSecretarjO-Theprovisionsofparagraph (2)(C) (relat-
20 ing to waiving appUcation of certain preexisting hmita-
21 tions) mayapplytotheenrollmentofanindi^'idualunder
22 a pohcypursuantto this paragraph. In the case ofsuch
23 anelection,theissuershalltreattheindividualashaving
24 beencoveredunderthepohcyduringtheperiodinwhich
25 theindividualwascoveredundertheMedicareselectpohcy
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1 forpurposesofcomputingapplicablepremiumsandapply-
2 inganypreexistingconditionlimitations.
3 "(B) The enrollment periods described in this sub-
4 paragraphare
5 "(i) an open enrollment period (of at least 30
6 days duration) at least once everj^ 12 months, and
7 "(ii) areasonableopenenrollmentperiodforan
8 individual whose coverage under a Medicare select
9 policy is terminated because the indi\idual moves
10 outoftheserviceareaoftheissuerofsuchMedicare
11 selectpohcy.
12 "(C)Anindividualdescribedinthissubparagraphis,
13 withrespecttotheissuerofaMedicaresupplementalpol-
14 icy, anindi^^dualwhoisenrolledinaMedicareselectpol-
15 icyandwhowouldbeehgibletoenrollundertheMedicare
16 supplementalpohcyoftheissuerunderparagraph (2)(A)
17 at thetime the indi\adualbecame (orbecomes) 65years
18 ofage.
19 "(D) In this paragraph, the term 'Medicare select
20 pohcy' means a pohcy issued and certified under sub-
21 section(t)(l).
22 "(E) TheSecretaryisauthorizedtoissueregulations
23 tocarrj'outthisparagraph.".
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1 (b) Effective Date. The amendments made by
2 subsection (a) shall apply to issuers ofMedicare supple-
3 mental pohcies for periods beginning with the first day
4 ofthe first month that begins more than 90 days after
5 thedateoftheenactmentofthisAct.
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