PROVIDENCE – Legislation to protect seniors on Medicare from being denied supplemental coverage or from being charged higher rates for preexisting conditions has become law.
Most individuals over 65 years old are eligible to enroll in Medicare, a health insurance plan from the federal government. Medicare has four parts, A, B, C and D.
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Medicare Part A covers hospitalizations and some other inpatient services. Part B covers doctors’ visits and some other outpatient services. Both are administered directly by the federal government and include costs such as deductibles, copays and coinsurance. Part D is prescription coverage.
Under Part C, seniors can purchase insurance from private companies to cover costs that Medicare Parts A and B do not cover such as copays, coinsurance and deductibles. Such plans are known as Medicare Advantage plans. Seniors who wish to enroll in a Medicare Advantage plan must do so during an initial open enrollment period (when they first become eligible for Medicare) or after a qualifying life event such as a move or loss of a job.
If a senior wishes to change their Medicare Advantage plan later on, they may be subject to a complex underwriting process including health screenings and blood work. Individuals can be charged higher rates or denied coverage due to pre-existing conditions.
“Many people don’t realize this could be a problem for them until it’s too late. They decide they want to change their health care plan and are denied or charged higher rates,” said Senator Valarie Lawson, D-East Providence, who sponsored the legislation along with Rep. Susan Donovan, D-Bristol. “This bill will ensure seniors, who have worked their whole lives, can choose the care plan that works for them without facing discrimination.”
The law prohibits insurers from subjecting seniors to this underwriting process, denying them coverage or charging higher rates due to pre-existing conditions, as long as the individual is currently enrolled in some Medicare Advantage plan and seeks to change plans during an annual open enrollment. Other states, including Massachusetts and Connecticut, have similar legislation.
“It’s really unconscionable [that] seniors can be denied medical insurance due to pre-existing medical conditions,” Donovan said. “This bill rights that wrong and ensures our seniors can obtain the coverage that’s right for them.”
The bill passed the General Assembly last month and was signed into law by Gov. Daniel J. McKee on June 26.
