Bill > SB242

This bill establishes an annual 90-day open enrollment period for Medicare supplement (Medigap) insurance coverage in California, starting January 1, 2027. Currently, individuals have a limited one-time open enrollment window when they first become eligible for Medicare Part B, which makes it difficult for people to switch coverage if their health needs or financial situations change. The bill would require insurance companies to accept applications for Medicare supplement coverage during this annual period without denying coverage or discriminating in pricing based on health status, medical conditions, claims experience, or age. The bill also specifies a structured age-based premium system with four age bands (under 65, 65-69, 70-79, and 80 and over), with restrictions on how premiums can be set relative to each other. Importantly, the legislation removes previous restrictions that excluded individuals with end-stage renal disease from obtaining Medicare supplement coverage and prohibits insurers from increasing premiums based on age after the initial policy is issued. The goal is to provide more flexibility and accessibility for Medicare beneficiaries in obtaining supplemental health insurance coverage, ensuring they can change plans without facing prohibitive costs or coverage denials due to their health status.

Budget and Finance, Health and Social Services

https://leginfo.legislature.ca.gov/faces/billStatusClient.xhtml?bill_id=202520260SB242