Bill > HB4869

This bill establishes specific circumstances under which individuals in West Virginia are guaranteed the right to purchase Medicare Supplement policies, which are health insurance policies designed to fill gaps in Medicare coverage. These guaranteed-issue rights are "clearly bounded," meaning they apply only under defined conditions and for limited periods. One key provision allows individuals to replace their existing Medicare Supplement policy once per calendar year during a 60-day window around their birthday, provided they have continuously held their current policy for at least 24 months and the replacement policy offers the same or lesser benefits. Another provision grants a guaranteed-issue right to individuals aged 65 or older who are eligible for Medicare and lose their Medicaid (medical assistance) eligibility, allowing them to purchase any Medicare Supplement policy actively sold in the state for 63 days after losing Medicaid. Importantly, during these guaranteed-issue periods, insurers cannot deny coverage, use medical underwriting, or impose pre-existing condition exclusions. The bill also mandates that the Insurance Commissioner provide an annual report to the Legislature on Medicare Supplement policy premium trends and grants the Commissioner rulemaking authority to administer these provisions without expanding the established eligibility or benefit scope.

Budget and Finance, Business and Industry

http://www.wvlegislature.gov/Bill_Status/Bills_history.cfm?input=4869&year=2026&sessiontype=RS&btype=bill