Existing federal law establishes the Medicare program, which is a public health insurance program for persons 65 years of age or older and specified persons with disabilities or end-stage renal disease who are less than 65 years of age. (42 U.S.C. §§ 1395 et seq.) Existing federal law defines the term “Medicare supplemental policy” to mean a policy offered by a private insurer that is primarily designed to pay expenses not reimbursed under Medicare because of certain limitations under Medicare. Existing federal law requires the issuance of a Medicare supplemental policy under certain circumstances but does not require a private insurer to sell or issue a Medicare supplemental policy to a person who is less than 65 years of age and enrolled in Medicare on the basis of a disability or end-stage renal disease. (42 U.S.C. § 1395ss) Section 4 of this bill requires an insurer that offers a Medicare supplemental policy in this State, including an insurer that provides coverage to state and local government employees, to allow a person who is less than 65 years of age and enrolled in Medicare on the basis of a disability or end-stage renal disease to purchase any Medicare supplemental policy that the insurer offers to new insureds in this State who are 65 years of age or older. Section 4 imposes certain limitations on the premium rate that such an insurer may charge such persons for a Medicare supplemental policy and prohibits insurers from imposing additional limitations, terms or conditions on such persons with respect to the policy that the insurer would not impose on persons who are 65 years of age or older. Existing law requires an insurer offering a Medicare supplemental policy to annually offer an open enrollment period for persons currently covered by a Medicare supplemental policy, during which the insurer is prohibited from taking certain actions with respect to the issuance or effectiveness of, or price charged for, a policy offered to a person during the open enrollment period. (NRS 687B.352) Section 4 requires an insurer to establish a similar open enrollment period which allows an eligible person who is less than 65 years of age to purchase a Medicare supplemental policy during a 6-month period commencing on the first day of the first month during which the person enrolled in coverage under Part B of Medicare, which provides coverage for certain medically necessary services provided outside of a hospital. During that open enrollment period, section 4 prohibits an insurer from taking certain actions with respect to the issuance or effectiveness of a policy offered to the person. Section 4 also prohibits an insurer from imposing an exclusion of benefits under a Medicare supplemental policy during that open enrollment period based on a preexisting condition. Section 6 of this bill adds a similar prohibition with regard to the open enrollment period established under existing law which will apply to both persons who are 65 years of age or older and persons who are less than 65 years of age and suffering from a disability or end-stage renal disease. Section 10 of this bill requires an insurer to establish a similar open enrollment period, which commences on October 1, 2025, and remains open through April 1, 2026, for persons who are: (1) less than 65 years of age; (2) suffering from a disability or end-stage renal disease; and (3) enrolled in coverage under Part B of Medicare as of October 1, 2025, on the basis of the disability or end-stage renal disease. Sections 7-9 of this bill establish the applicability of section 4 to: (1) a hospital or medical services corporation; and (2) state and local governments that offer insurance to employees. Section 3 of this bill defines the term “Medicare supplemental policy” to have the same meaning as is ascribed to it in federal regulations, and section 2 of this bill establishes the applicability of that definition. Sections 5 and 6 of this bill make conforming changes to remove duplicative language from other existing provisions.

Statutes affected:
As Introduced: 687B.015, 687B.352, 695B.320, 287.010, 287.04335
Reprint 1: 687B.015, 687B.352, 695B.320, 287.010, 287.04335
As Enrolled: 687B.015, 687B.352, 695B.320, 287.010, 287.04335
BDR: 687B.015, 687B.352, 695B.320, 287.010, 287.04335