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HB 8595

AN ACT RELATING TO INSURANCE -- MEDICARE SUPPLEMENT INSURANCE POLICIES

2026 Regular Session Introduced by Lauren Carson and 9 co-sponsors

Expands guaranteed issue rights and regulatory protections for Medigap, including under-65 disability/ESRD applicants, nonduplication of coverage, and enhanced issuer disclosures.

06/22/2026 Signed by Governor
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WeVote Research Nonpartisan
Bill Summary · HB 8595

Summary: HB 8595 (Rhode Island, 2026) – Medicare Supplement Insurance Policies

Main purpose and intent

  • Expand guaranteed issue rights and protections for individuals applying for Medicare supplement (Medigap) policies outside of a plan’s initial enrollment period.
  • Align state standards with federal protections while giving the Rhode Island Department of Insurance authority to regulate policy provisions, premium practices, and disclosures for Medicare supplement policies.

Key provisions and changes

  • Policy provisions standards (27-18.2-3(a)-(f))

    • Prohibits Medicare supplement policies from duplicating Medicare benefits.
    • Prohibits excluding or limiting coverage for preexisting conditions beyond six months from the effective date; defines preexisting condition consistently with medical advice/treatment within six months prior to coverage.
    • authorizes the Insurance Commissioner to adopt regulations establishing:
    • Renewal terms
    • Eligibility criteria
    • Nonduplication of coverage
    • Probationary periods
    • Benefit limitations, exceptions, and reductions
    • Elimination periods
    • Replacement requirements
    • Recurrent conditions and definitions
    • Allows the Commissioner to prohibit unjust or unfairly discriminatory provisions not expressly authorized by statute.
    • Requires minimum standards for premium rates, benefits, claims payment, marketing practices, and compensation/reporting for Medicare supplement policies.
    • Enables conformity rules with federal law, including:
    • Refunds/credits for not meeting loss ratio requirements
    • Uniform loss ratio calculation/reporting
    • Public access to policy, premium, and loss ratio information
    • Process for approving/disapproving policy forms and premium increases
    • Policy for public hearings prior to premium increase approvals (including 10 days’ notice to subscribers)
    • Standards for Medicare SELECT policies

  • Access and issuance for under-65 individuals (g)

    • Any Medicare Plan A policy or applicable certificate currently offered in RI must be made available to applicants under 65 who are eligible for Medicare due to disability or ESRD, if they apply within six months of initial Medicare Part B eligibility or the applicable alternate enrollment period.
    • Issuance/coverage cannot be conditioned on health status or health care receipt; no medical underwriting for these applicants.
    • If under 65 and enrolled due to disability/ESRD, they receive a six-month open enrollment period for any policy the issuer currently offers in Rhode Island, starting when the individual turns 65 and remains enrolled in Medicare A & B.

  • Guaranteed issue rights during AEP and beyond (h)

    • During the Medicare Annual Enrollment Period (AEP), for an individual with no gaps in credible coverage since the Initial Enrollment Period, guaranteed issue rights apply for any available Medigap policy that Rhode Island issuers offer.
    • Issuance cannot be conditioned on health status; no medical underwriting for policies issued under this subsection.
    • For under-65 individuals under disability/ESRD enrolled in a Medicare Advantage or Plan A, guaranteed issue rights apply to every Plan A Medicare supplement policy made available in the state, under the terms of subsection (h)(1).

  • Effective date

    • The act takes effect upon passage.

Who or what would be affected

  • Medicare-eligible individuals seeking Medigap coverage in Rhode Island, including:
    • Those under age 65 with disability or ESRD who become eligible for Medicare
    • Individuals transitioning to Medicare during the AEP
    • Current and prospective Medigap policyholders and applicants
  • Insurance issuers offering Medicare supplement policies in Rhode Island
  • The Rhode Island Insurance Commissioner and the RI Department of Business Regulation for regulatory standards, loss ratio methodologies, rate approvals, and forms review
  • Consumers and the public with enhanced access to policy information, premiums, and loss ratios

Procedural and timeline aspects

  • Referred to the Rhode Island House Health & Human Services Committee upon introduction (May 27, 2026).
  • The act contains no specified sunset or transitions beyond taking effect upon passage; regulations would be developed by the Commissioner to implement standards in alignment with federal requirements.
  • Potential for public hearings prior to premium increases, as part of the regulations established under the act.

Potential impact

  • Strengthened protections for Medigap applicants, particularly those outside the initial enrollment window and under-65 individuals with disability/ESRD.
  • Greater non-discrimination in underwriting and preexisting-condition handling for certain groups.
  • Increased regulatory oversight of premiums, loss ratios, and marketing practices, with possible effects on premium pricing and issuer transparency.
  • Expanded guaranteed issue access during AEP and for under-65 disability/ESRD enrollees, reducing barriers to obtaining Medigap coverage.

Compiled from official sources — confirm details with the bill’s official record.

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