Maryland Code § IN-15-909

Section IN-15-909
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(a) 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.
(b) (1) 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:
(i) 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
(ii) 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.
(2) Notwithstanding paragraph (1)(ii) or (6)(iii)2 of this subsection, a
carrier may include in a Medicare supplement policy a provision that complies with
subsection (d) of this section.
(3) (i) 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:
1. during the 6-month period following the applicant's
enrollment in Part B of Medicare; or
2. 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.
(ii) For a Medicare supplement policy plan A or D required to
be made available under subparagraph (i) of this paragraph, a carrier:
1. 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

2. 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.
(iii) 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.
(4) 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 (3)(i) of this subsection.
(5) Nothing in paragraph (3) of this subsection may 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.
(6) (i) This paragraph applies only on and after July 1, 2023.
(ii) 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.
(iii) 1. For purposes of this paragraph, a Medicare
supplement policy has equal or lesser benefits unless:
A. it contains one or more significant benefits not
included in the Medicare supplement policy being replaced; or
B. 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.
2. The Commissioner shall adopt regulations
establishing a matrix for identifying which Medicare supplement policies have equal
or lesser benefits.
(iv) For a Medicare supplement policy required to be made
available under subparagraph (ii) of this paragraph, a carrier may not:

1. 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
2. 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.
(v) 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.
(c) 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.
(d) (1) 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.
(2) 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.
(e) 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.
(f) 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.
(g) (1) (i) 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.

(ii) The carrier shall offer the certificate holder at least the
following:
1. an individual Medicare supplement policy that
provides for continuation of the benefits contained in the group policy; or
2. an individual Medicare supplement policy that
provides only the benefits that are required under § 15-906(a) of this subtitle.
(2) If membership in a group is terminated, the carrier:
(i) shall offer the certificate holder the conversion options
under paragraph (1) of this subsection; or
(ii) at the option of the group policyholder, shall offer the
certificate holder a continuation of coverage under the group Medicare supplement
policy.
(3) (i) 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.
(ii) 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.

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