On Friday, June 20, the Rhode Island House passed SB610, Sub B, joining the Senate in approving a birthday rule and evaluation of adopting community rating for all Medicare Supplement plans.  SB 610 is awaiting the Governor’s signature.

SB 610 does a number of things, including establishing a guaranteed-issue 6-month open enrollment period for individuals under-age 65 enrolled in a Medicare supplement (Medigap) plan who wish to switch to a different plan upon turning age 65.  While all individuals turning age 65 who enroll in Medicare Part B are entitled to this 6-month open enrollment period, this language eliminates any confusion for under-age 65 individuals already covered by a Medigap plan whether they are eligible for this open enrollment period, which allows them to switch to a different Medigap plan without medical underwriting.

The legislation includes a “birthday rule” providing guaranteed issue rights (no medical underwriting) that allows Enrollees to switch either to a different Medigap plan, or from Medicare Advantage to a Medigap plan.  And, under-age 65 individuals with Medicare Advantage coverage can switch to every Medigap Plan A policy (meaning Plan A from any insurer writing plans in Rhode Island) without medical underwriting. Instead of a time period around the Enrollees birthday to make plan changes, this section of SB610 is effective for the duration of the Medicare Annual Enrollment Period (AEP).  Please check with your dialysis center financial counselor to learn more about the AEP.

The original language of SB610 moved all Medicare Supplement coverage to community rating, instead of attained age, issue age or gender as the plan rating instrument.  A last-minute amendment submitted to the House Health & Human Services Committee eliminated that language, replacing it with language that directed the Office of the Health Insurance Commissioner to evaluate the impact of adopting a community rating structure for Medicare supplement plans and certificates.

DPC is pleased that SB 610 provides individuals with a way to switch Medigap plans and switch back to Original Medicare from Medicare Advantage coverage, and will continue to collaborate with the sponsors of SB610 and the Health Insurance Commissioner towards equitable premium rates for under-age 65 Rhode Islanders with End Stage Renal Disease.