Bill > HB4869

This bill establishes specific circumstances under which individuals in West Virginia are guaranteed the right to purchase Medicare Supplement (Medigap) policies, which are designed to cover gaps in Medicare coverage. Firstly, individuals enrolled in a Medigap policy will have a guaranteed issue right once per year, starting on their birthday and lasting for 60 days, allowing them to replace their current policy with one from the same insurer or an affiliated insurer that offers the same or lesser benefits, without facing denial, medical underwriting, or pre-existing condition exclusions. Secondly, individuals aged 65 or older who are eligible for Medicare and lose their Medicaid (medical assistance) eligibility will also have a guaranteed issue right for 63 days to purchase any Medigap policy offered in the state, again without denial, medical underwriting, or pre-existing condition exclusions, regardless of their prior Medigap enrollment or Medicaid eligibility at the time they became eligible for Medicare. The bill also mandates that the Insurance Commissioner provide an annual report to the Legislature on Medigap premium trends and grants the Commissioner rulemaking authority to administer these provisions without expanding the scope of eligibility or benefits beyond what is outlined.

Budget and Finance, Business and Industry

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