Bill > A4834

Introduced Session

This bill prohibits health insurance companies, health service corporations, hospital service corporations, medical service corporations, and health maintenance organizations that issue Medicare supplement insurance policies or contracts in the State: (1) from denying or conditioning the effectiveness or issuance, or discriminating in the pricing, of Medicare supplement insurance policies or contracts based on the health status, claims experience, receipt of health care by, or medical condition of an applicant; and (2) from excluding benefits based on an applicant's preexisting medical condition. Under the bill, these provisions only apply when the application for Medicare supplement coverage is submitted on or after the first day of the first month in which the applicant is 65 years of age or older and the applicant is enrolled for benefits under Medicare Part B. Medicare supplement insurance, also known as "medigap" insurance, is sold by private insurance companies and can help pay some of the out-of-pocket costs associated with Medicare Part A and Medicare Part B, such as copayments, coinsurance, deductibles and other fees. The types of consumer protections provided under this bill are collectively known as guaranteed issue rights and prohibit health insurance carriers from denying an applicant a Medicare supplement insurance policy or contract based on factors such as age, gender, or health status, and from varying premiums based on an applicant's pre-existing medical conditions. Currently in New Jersey, applicants are provided guaranteed issued rights to Medicare supplement insurance during a one-time, six-month open enrollment period for beneficiaries ages 65 and older when enrolling in Medicare Part B, and for certain qualifying events which generally include instances when Medicare beneficiaries involuntarily lose supplemental coverage. Medicare beneficiaries who miss these enrollment opportunities may unknowingly forfeit the chance to purchase Medicare supplement insurance later in life. This bill addresses this issue by providing continuous guaranteed issue rights to applicants ages 65 and older who are also enrolled for benefits under Medicare Part B.

Committee Categories

Yvonne Lopez (D)*,  Lisa Swain (D)*,  Chris Tully (D)*, 

Introduced, Referred to Assembly Health and Senior Services Committee (on 01/15/2019)