Bill
HB 2775
Expands guaranteed‑issue access for Medigap when moving from Medicare Advantage back to Original Medicare, allowing a 30‑day window with no higher premiums or preexisting‑condition
Status & procedural notes
- Bill number: HB 2775
- Primary sponsor(s) (in provided document): Rep. Martha Deuter (introduced); Christopher Mathis listed among sponsors in the mixed document.
- Introduced: February 2025 (document shows 2/6/2025 and 2/13/2025 entries).
- Current status (per provided info): Rule 19(a) / Re‑referred to Rules Committee; previously assigned to the Insurance Committee and Insurance Main Subcommittee.
- Statutory change: Amends the Illinois Insurance Code, 215 ILCS 5/363 (Medicare supplement policies; minimum standards).
Note about source material: The supplied file appears to combine two different bills (an Illinois bill about Medicare supplement policies and an unrelated Arizona bill on historic‑preservation responsibilities for community college districts). The summary below focuses on the Illinois Medicare supplement provisions included in the document.
Purpose and intent
- To expand guaranteed‑issue protections for Medicare supplement (Medigap) policies so individuals who voluntarily switch from a Medicare Advantage (MA) plan back to Original Medicare (Parts A, B, or D, or any combination) can obtain a Medigap policy without being denied coverage or charged higher rates, provided they apply promptly.
Key provisions
- New guaranteed‑issue window: An issuer of a Medicare supplement policy shall not deny coverage to an applicant who voluntarily switches from a Medicare Advantage plan to Medicare Parts A, B or D (or combinations) if the application for a Medigap policy is submitted within 30 calendar days after the first effective day of the new Original Medicare plan.
- Price and underwriting limits: When the application is timely (within the 30‑day window), the issuer:
- May not charge a higher premium than normally offered to applicants who have become newly eligible for Medicare, and
- May not raise premiums or deny coverage based on a preexisting condition.
- Cross‑reference for “preexisting condition”: The bill uses the definition of preexisting condition found in Section 351A‑5 of the Code.
- Retains and supplements existing guaranteed‑issue situations already listed in 215 ILCS 5/363 (e.g., Medicare eligibility by disability, loss of employer group coverage, insurer withdrawal or termination, moves out of an MA plan area, MA contract termination or marketing misrepresentation).
Who is affected
- Beneficiaries: Medicare beneficiaries who leave Medicare Advantage and return to Original Medicare — they would have a 30‑day guaranteed access period to buy Medigap coverage without higher premiums or preexisting‑condition exclusions.
- Issuers: Insurers, HMOs, fraternal societies, voluntary health service plans, and other entities that issue Medicare supplement policies in Illinois would be restricted from denying coverage or applying higher rates in the 30‑day window.
- Agents/brokers and employers: Entities that market Medicare products will need to follow the new guaranteed‑issue rule and inform applicants accordingly.
Potential impact and considerations
- Improves access to Medigap coverage for people who opt out of Medicare Advantage, reducing the risk that switching will leave them unable to obtain supplemental coverage or face higher costs due to underwriting.
- Could lead issuers to manage adverse selection risk through other premium rating rules permitted elsewhere in statute, but the bill explicitly restricts higher charges and preexisting exclusions in the 30‑day window.
- Implementation will require administrative updates by issuers and outreach to beneficiaries to ensure timely applications within the 30‑day period.
Recommendation
- Verify the final bill text and jurisdiction (Illinois) before relying on the mixed document. If tracking progression, monitor committee reports and Rule 19(a) actions for amendments or changes.
Compiled from official sources — confirm details with the bill’s official record.
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