Until recently, insurance companies in Indiana were required to offer at least one type of Medicare Supplement (or “Medigap”) plan to younger beneficiaries under 65, but those with Stage Renal Disease (ESRD) were exempt from the law. This meant that people with ESRD had an extremely hard time finding affordable coverage.

However, a new law has been passed that changes this rule and makes Medigap more accessible to everyone. Below, this supplemental insurance broker in Kouts, Indiana is going to explain this new law in detail.

More Medigap options for people under 65

In 2024, Indiana introduced a new law called Senate Enrolled Act (“SEA”) 215 that will require all insurance companies in the state to offer every Medigap plan to Medicare beneficiaries under 65 (including those with ESRD) starting January 1, 2025.

Before this, younger Medicare beneficiaries only had access to one Medigap plan, which made it very difficult to find the right coverage. Many of them struggled with high costs, limited benefits, and fewer choices compared to older beneficiaries. But now, they have access to multiple plans and can easily find the best coverage for their medical needs and budget.

This change is a big deal because many younger Medicare beneficiaries under 65 with disabilities experience more insurance-related problems than older beneficiaries. Many of them have serious health conditions and need additional financial support to manage their medical expenses. This new law makes sure that Medicare beneficiaries in Indiana get equal access to Medigap, regardless of age or health condition.

No more denials for health conditions

Before this law, many insurance companies denied Medigap coverage to people with serious health conditions or charged them much higher premiums. This was especially true for those with preexisting conditions like ESRD. The new law changes this by preventing insurance companies from rejecting applicants based on their health history, past claims, or preexisting conditions.

Special enrollment periods

The new law includes special enrollment periods for younger beneficiaries to make sure everyone has a fair chance to enroll. If a person under 65 was already enrolled in Medicare before January 1, 2025, they will get a special six-month enrollment period from January 1 to June 30, 2025. During this period, they can choose any Medigap plan without going through medical underwriting. In other words, their health condition will not affect their ability to get coverage.

For those who enroll in Medicare after January 1, 2025, a six-month Medigap Open Enrollment Period will start the month they start their Medicare Part B coverage. This makes sure that all new Medicare beneficiaries have a guaranteed opportunity to sign up for Medigap without being denied or overcharged.

If you want to learn more about these guaranteed issue rights and when to enroll, you should talk to an experienced supplemental insurance broker in Kouts, Indiana. They will help you understand the different options available so you can make the best choice for your health and future.

New fair pricing rules for Medigap plans

Many younger Medicare beneficiaries have been worried about the high costs of Medigap plans, but this law has also introduced new pricing rules to make things fairer. Under the new law, insurance companies can no longer charge people under 65 more than they charge those who are 65 and older for certain Medigap plans. For example, Medigap Plans A, B, and D must have the same premium rates for all beneficiaries, regardless of age.

For other Medigap plans, the premiums for younger beneficiaries cannot be more than 200% of what a 65-year-old would pay for the same plan. While some younger beneficiaries may still pay a bit more, the new law prevents extreme price hikes. Insurance companies are also no longer allowed to delay coverage or exclude preexisting conditions. Therefore, once someone enrolls in a Medigap plan, they can start using their benefits immediately.

These changes will protect younger Medicare beneficiaries from being overcharged and make sure they have access to affordable healthcare coverage. If you have questions about the cost of Medigap premiums, a knowledgeable supplemental insurance broker in Kouts, Indiana can help you compare different plans and find the most cost-effective option for you.

Looking for a Supplemental Insurance Broker in Kouts, Indiana?

Are you ready to sit down with a knowledgeable supplemental insurance broker in Kouts, Indiana that can help you with all aspects of your healthcare coverage? If so, Senior Care Insurance Services is the top choice. We are here to help you understand your options and find the best coverage for your healthcare needs. Contact us today to begin the process.