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Bill

Bill

SB 242

Medicare supplement coverage: open enrollment periods.

2025-2026 Regular Session Introduced by Dawn Addis and 16 co-sponsors

SB 242 expands California Medicare supplement open enrollment periods, allowing beneficiaries greater flexibility to switch plans outside standard federal windows.

May 23 hearing: Held in committee and under submission.
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WeVote Research Nonpartisan
Bill Summary · SB 242

Legislative bill overview

SB 242 modifies California's regulations governing open enrollment periods for Medicare supplement insurance (Medigap) coverage. The bill appears to expand or clarify when individuals can enroll in or switch between supplemental health plans outside standard Medicare enrollment windows. This would give California beneficiaries greater flexibility in accessing supplemental coverage options.

Why is this important

Medicare supplement insurance helps cover costs that Original Medicare doesn't pay, including copayments, coinsurance, and deductibles. Restrictive enrollment periods can lock seniors into inadequate or expensive plans. Expanding open enrollment access could reduce healthcare affordability barriers for California's large senior population and allow them to respond to changing health needs or plan performance.

Potential points of contention

  • Insurance industry costs: Broader enrollment periods increase administrative complexity and potentially higher claims costs for insurers, which may be passed to consumers through higher premiums
  • Adverse selection risk: Expanded enrollment windows may incentivize people to delay coverage until they develop health problems, destabilizing risk pools and premiums for continuous enrollees
  • State vs. federal authority: Medicare supplement regulation involves federal oversight; California's modifications must coordinate with federal rules, potentially creating compliance complications

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

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