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<section article="gin" article_name="Insurance" number="15-909" title_number="15" title_name="Health Insurance" subtitle_number="9" subtitle_name="Medicare Supplement Act">
  <level label="a">
    <text>This section does not extend the number of days of hospitalization offered under § 15–906(a) of this subtitle to the extent those days of hospitalization have been used under the original Medicare supplement policy.</text>
  </level>
  <level label="b">
    <level label="1">
      <text>If an application for a Medicare supplement policy or certificate is submitted during the 6–month period beginning with the first month in which an individual who is at least 65 years old first enrolls for benefits under Medicare Part B, a carrier:</text>
      <level label="i">
        <text>may not deny or condition the issuance or effectiveness of the Medicare supplement policy or certificate or discriminate in the pricing of the Medicare supplement policy or certificate because of the health status, claims experience, receipt of health care, or medical condition of the applicant; or</text>
      </level>
      <level label="ii">
        <text>may not deny, reduce, or condition coverage or apply an increased premium rating to an applicant for a Medicare supplement policy because of the health status, claims experience, or medical condition of the applicant or the use of medical care by the applicant.</text>
      </level>
    </level>
    <level label="2">
      <text>Notwithstanding paragraph (1)(ii) or (8)(iii)2 of this subsection, a carrier may include in a Medicare supplement policy a provision that complies with subsection (d) of this section.</text>
    </level>
    <level label="3">
      <text>A carrier that issues Medicare supplement policies in the State shall issue any Medicare supplement policy the carrier sells to an individual eligible for Medicare if the individual:</text>
      <level label="i">
        <text>was enrolled in Medicare Part B while enrolled in the Maryland Medical Assistance Program;</text>
      </level>
      <level label="ii">
        <text>was not disenrolled or terminated from the Maryland Medical Assistance Program until at least 6 months following the effective date of enrollment in Medicare Part B;</text>
      </level>
      <level label="iii">
        <text>applies for the Medicare supplement policy during the 63–day period following the later of notice of termination or disenrollment or the date of termination from the Maryland Medical Assistance Program; and</text>
      </level>
      <level label="iv">
        <text>submits evidence of the date of termination or disenrollment from the Maryland Medical Assistance Program with the application for a Medicare supplement policy.</text>
      </level>
    </level>
    <level label="4">
      <text>A carrier that issues Medicare supplement policies in the State shall issue any Medicare supplement policy currently open to new enrollees to an individual eligible for Medicare if the individual:</text>
      <level label="i">
        <text>became eligible for Medicare before January 1, 2020;</text>
      </level>
      <level label="ii">
        <text>qualifies under any federal special enrollment period guaranteed issue right, including for plans issued on or after January 1, 2020;</text>
      </level>
      <level label="iii">
        <text>applies for the Medicare supplement policy during the 63–day period following the qualifying event for the federal special enrollment period guaranteed issue right; and</text>
      </level>
      <level label="iv">
        <text>submits evidence of the date of the qualifying event for the federal special enrollment period guaranteed issue right with the application for a Medicare supplement policy.</text>
      </level>
    </level>
    <level label="5">
      <level label="i">
        <text>A carrier shall make available Medicare supplement policy plans A and D to an individual who is under the age of 65 years but is eligible for Medicare due to a disability, if an application for a Medicare supplement policy or certificate is submitted:</text>
        <level label="1">
          <text>during the 6–month period following the applicant’s enrollment in Part B of Medicare; or</text>
        </level>
        <level label="2">
          <text>if the applicant is notified by Medicare of the applicant’s retroactive enrollment in Medicare, during the 6–month period following notification of enrollment in Medicare.</text>
        </level>
      </level>
      <level label="ii">
        <text>For a Medicare supplement policy plan A or D required to be made available under subparagraph (i) of this paragraph, a carrier:</text>
        <level label="1">
          <text>may not deny or condition the issuance or effectiveness of a Medicare supplement policy plan A or D because of the health status, claims experience, receipt of health care, or medical condition of the applicant; or</text>
        </level>
        <level label="2">
          <text>may not deny, reduce, or condition coverage to the applicant for a Medicare supplement policy plan A or D because of the health status, claims experience, or medical condition of the applicant or the use of medical care by the applicant.</text>
        </level>
      </level>
      <level label="iii">
        <text>For a Medicare supplement policy plan A required to be made available under subparagraph (i) of this paragraph, a carrier may not charge individuals who are under the age of 65 years, but are eligible for Medicare due to a disability, a rate higher than the average of the premiums paid by all policyholders age 65 and older in the State who are covered under that plan A policy form.</text>
      </level>
    </level>
    <level label="6">
      <text>A carrier may elect to offer Medicare supplement policy plans to individuals who are under the age of 65 years, but eligible for Medicare due to a disability, in addition to the Medicare supplement policy plans A and D that are required to be offered under paragraph (5)(i) of this subsection.</text>
    </level>
    <level label="7">
      <text>Paragraph (5) of this subsection may not be construed to require a carrier to offer a Medicare supplement policy plan to individuals who are under the age of 65 years, but are eligible for Medicare due to a disability, if the plan is not offered to individuals who are eligible for Medicare due to age.</text>
    </level>
    <level label="8">
      <level label="i">
        <text>This paragraph applies only on and after July 1, 2023.</text>
      </level>
      <level label="ii">
        <text>During the 30 days following the birthday of an individual enrolled in a Medicare supplement policy, a carrier shall make available to the individual different Medicare supplement policies with benefits that are equal to or less than the benefits of the individual’s existing coverage.</text>
      </level>
      <level label="iii">
        <level label="1">
          <text>For purposes of this paragraph, a Medicare supplement policy has equal or lesser benefits unless:</text>
        </level>
        <level label="A">
          <text>it contains one or more significant benefits not included in the Medicare supplement policy being replaced; or</text>
        </level>
        <level label="B">
          <text>it contains the same significant benefits included in the Medicare supplement policy being replaced but it reduces the cost–sharing responsibilities of the enrollee for the benefits.</text>
        </level>
        <level label="2">
          <text>The Commissioner shall adopt regulations establishing a matrix for identifying which Medicare supplement policies have equal or lesser benefits.</text>
        </level>
      </level>
      <level label="iv">
        <text>For a Medicare supplement policy required to be made available under subparagraph (ii) of this paragraph, a carrier may not:</text>
        <level label="1">
          <text>deny or condition the issuance or effectiveness of a Medicare supplement policy, or discriminate in the pricing of the policy, because of the health status, claims experience, or medical condition of the individual or the receipt of health care by the individual; or</text>
        </level>
        <level label="2">
          <text>deny, reduce, or condition coverage to the individual for a Medicare supplement policy because of the health status, claims experience, or medical condition of the individual or the use of medical care by the individual.</text>
        </level>
      </level>
      <level label="v">
        <text>A carrier that offers Medicare supplement policies shall notify an insured of the insured’s rights under this paragraph at least 30 days, but not more than 60 days, before the insured’s birthday.</text>
      </level>
    </level>
  </level>
  <level label="c">
    <text>Regardless of the applicant’s age, each Medicare supplement policy or applicable certificate that a carrier currently has available shall be made available to each applicant who qualifies under subsection (b) of this section.</text>
  </level>
  <level label="d">
    <level label="1">
      <text>Notwithstanding any other provision of law, a Medicare supplement policy or certificate may not exclude or limit benefits for losses incurred more than 6 months after the effective date of coverage because the losses involved a preexisting condition.</text>
    </level>
    <level label="2">
      <text>A Medicare supplement policy or certificate may not define a preexisting condition more restrictively than a condition for which a physician gave medical advice or recommended or gave treatment within 6 months before the effective date of coverage.</text>
    </level>
  </level>
  <level label="e">
    <text>If a Medicare supplement policy or certificate replaces another Medicare supplement policy or certificate, the succeeding carrier shall waive the time periods applicable to preexisting conditions, waiting periods, elimination periods, and probationary periods in the new Medicare supplement policy or certificate for similar benefits to the extent the time was spent under the original Medicare supplement policy or certificate.</text>
  </level>
  <level label="f">
    <text>A carrier may not cancel or nonrenew a Medicare supplement policy or certificate for any reason other than for nonpayment of premium or material misrepresentation.</text>
  </level>
  <level label="g">
    <level label="1">
      <level label="i">
        <text>If the group policyholder terminates a group Medicare supplement policy without replacing the group Medicare supplement policy under paragraph (3) of this subsection, the carrier shall offer each certificate holder an individual Medicare supplement policy.</text>
      </level>
      <level label="ii">
        <text>The carrier shall offer the certificate holder at least the following:</text>
        <level label="1">
          <text>an individual Medicare supplement policy that provides for continuation of the benefits contained in the group policy; or</text>
        </level>
        <level label="2">
          <text>an individual Medicare supplement policy that provides only the benefits that are required under § 15–906(a) of this subtitle.</text>
        </level>
      </level>
    </level>
    <level label="2">
      <text>If membership in a group is terminated, the carrier:</text>
      <level label="i">
        <text>shall offer the certificate holder the conversion options under paragraph (1) of this subsection; or</text>
      </level>
      <level label="ii">
        <text>at the option of the group policyholder, shall offer the certificate holder a continuation of coverage under the group Medicare supplement policy.</text>
      </level>
    </level>
    <level label="3">
      <level label="i">
        <text>If a group Medicare supplement policy is replaced by another group Medicare supplement policy purchased by the same policyholder, the succeeding carrier shall offer coverage to each individual who was covered under the old group Medicare supplement policy on its date of termination.</text>
      </level>
      <level label="ii">
        <text>Under the new group Medicare supplement policy, coverage may not be excluded for a preexisting condition that would have been covered under the group Medicare supplement policy being replaced.</text>
      </level>
    </level>
  </level>
</section>
