Medicare Supplement Guaranteed Issue Special Enrollment Period

Indiana Department of Insurance

April 20, 2023

Bulletin 269

MEDICARE SUPPLEMENT GUARANTEED ISSUE

SPECIAL ENROLLMENT PERIOD

The purpose of this bulletin is to advise all issuers, as defined at IC 27-8-13-7.3, writing

Medicare Supplement policies, as defined at IC 27-8-13-3, ("Insurers"), and Hoosiers

continuously enrolled in Medicaid because ofthe COVID-19 Public Health Emergency ("PHE"),

of changes to federal law impacting Medicare enrollment and eligibility periods. These changes

create a special Medicare enrollment period for people who were unable to enroll in Medicare

due to the PHE. Additionally, many Hoosiers may have missed their initial enrollment period to

obtain Medicare Supplement insurance or would have been prevented from enrolling because

federal law prevents the sale of Medicare Supplement insurance to Medicaid members. To

ensure Hoosiers have access to the coverage they could have obtained if not for the PHE, the

Department directs Insurers to guarantee the issue of Medicare Supplement policies available in

Indiana to applicants as set forth in this bulletin.

Due to the PHE, the Families First Coronavirus Response Act ("FFCRA") was signed

into law on March 18, 2020. The FFCRA required Medicaid programs to keep members

continuously enrolled in coverage through the end of the month following the end of the PHE.

Accordingly, Indiana stopped disenrolling members from Medicaid coverage in the spring of

2020 to ensure members were able to continuously keep their coverage without interruption.

On December 29, 2022, the Consolidated Appropriations Act of2023 was signed into

law, which included a provision ending the continuous enrollment requirement. Effective April

1, 2023, Medicaid programs began following the regular rules for Medicaid eligibility once

again. As a result, Indiana Medicaid has started the Medicaid Unwinding process, which requires

Indiana to redetermine the eligibility of all Medicaid members

nsolidated Appropriations Act of2023 was signed into

law, which included a provision ending the continuous enrollment requirement. Effective April

1, 2023, Medicaid programs began following the regular rules for Medicaid eligibility once

again. As a result, Indiana Medicaid has started the Medicaid Unwinding process, which requires

Indiana to redetermine the eligibility of all Medicaid members. The redetermination process will

be completed within approximately twelve (12) months, and Indiana Medicaid will return to

normal operations in May 2024. During the Medicaid Unwinding process, members who are no

longer eligible for Medicaid coverage will be disenrolled and must transition to other coverage,

including any individuals who may be eligible for Medicare.

Typically, Hoosiers who become eligible for Medicare receive a Medicare Supplement

open enrollment period of six (6) months. 760 IAC 3-9-1. During open enrollment, Insurers must

offer guaranteed issue rights to all applicants and are prohibited from price discrimination based

on an applicant's health status. Insurers are also prohibited from selling Medicare Supplement

policies to Medicaid members under federal law. See 42 U.S.C. § 1395ss(d)(3)(B)(iii). However,

because ofthe continuous enrollment requirement, many Indiana Medicaid members who

became eligible for Medicare during the PHE may have already exhausted their six (6)-month

open enrollment period.

based

on an applicant's health status. Insurers are also prohibited from selling Medicare Supplement

policies to Medicaid members under federal law. See 42 U.S.C. § 1395ss(d)(3)(B)(iii). However,

because ofthe continuous enrollment requirement, many Indiana Medicaid members who

became eligible for Medicare during the PHE may have already exhausted their six (6)-month

open enrollment period.

To ensure eligible Hoosiers may access coverage they could have obtained ifnot for the

PHE, the Department directs Insurers writing Medicare Supplement policies to guarantee the

issue ofany Medicare Supplement policies available in Indiana to applicants who:

1. Are enrolled in Medicare Part B while enrolled in Medicaid;

2. Remained enrolled in Medicaid because ofthe federal continuous enrollment

requirement during the PHE and were not disenrolled from Medicaid coverage

until at least six (6) months following the effective date ofenrollment in

Medicare Pait B, or enrolled in Part B for the first time following

disemollment from Medicaid;

3. Apply for the Medicare Supplement policy during the 63 days following the

later oftheir notice oftermination or disenrollment from Medicaid or their

date of termination or disenrollment from Medicaid, or apply during the six

(6)-month period following the first day ofthe first month in which the

applicant is enrolled in Part B; and

4. Submit evidence ofthe date oftermination or disenrollment from Medicaid

(such as a copy ofthe "final closure notice" from Indiana Medicaid) with the

application for a Medicare Supplement policy.

By issuing this directive, the Department is ensuring applicants who missed their typical initial

enrollment period because ofcontinuous enrollment in Medicaid during the PHE will receive

guarantee issue rights to Medicare Supplement policies, including Hoosiers who are dual eligible

(i.e., Hoosiers eligible for both Medicare and Medicaid)

ith the

application for a Medicare Supplement policy.

By issuing this directive, the Department is ensuring applicants who missed their typical initial

enrollment period because ofcontinuous enrollment in Medicaid during the PHE will receive

guarantee issue rights to Medicare Supplement policies, including Hoosiers who are dual eligible

(i.e., Hoosiers eligible for both Medicare and Medicaid).

The Commissioner encourages Hoosiers to contact Indiana's State Health Insurance

Assistance Program (SHIP) with questions. SHIP assistance is available online at

https://vvww.in.gov/ship or by telephone at 1-800-452-4800. Questions about this bulletin may be

directed to Compliance@idoi.IN.gov.

INDIANA DEPARTMENT OF INSURANCE

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