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Individual Health

Under 65 and Disabled Rights Beginning June 1, 2008
By Linda Medrano, CDHC Brokerage Coordinator

With the passage of Public Act 95-0436, persons under 65 with disabilities who become eligible for Medicare will have additional rights. Illinoisans under age 65 who receive Medicare because of disabilities have the same open enrollment rights as seniors. During open enrollment, a company must allow you to buy any of the Medigap plans it offers. This right is also available for persons who are retroactively enrolled in Medicare Part B due to a retroactive eligibility decision made by the Social Security Administration if they apply within 6 months after receiving notice of retroactive eligibility.

Open enrollment will apply to all under 65 Medicare eligible individuals even if they have existing Medicare supplement insurance. If you fit this description, you will be able to choose from any plan offered by companies selling Medicare Supplement insurance in Illinois until December 1, 2008.

In addition, if you are under 65 and on Medicare but declined a Medigap policy because you were still covered under an employer group health plan, you will have a 63-day open enrollment period if the employer plan terminates or ceases to provide health benefits that supplement Medicare. Similarly, if you are either currently enrolled in a Medicare Advantage plan or have a Medigap policy and the insurance company goes out of business, withdraws from the market or misrepresented the product you purchased, you also will be eligible for a 63-day open enrollment period under most circumstances.

More importantly is the cost of coverage. For persons under 65 that become eligible to purchase a Medigap policy, companies may not charge a rate higher than the highest rate on the company’s current rate schedule filed with the Illinois Division of Insurance.

Obviously both of our Medicare Supplement Carriers will be complying with this law. Remember that you must select the highest rate (for BC/BS that is the 80+ rate) and for Mutual of Omaha you would use the 90+ rate. In a surprising turn of events BC/BS has recently REVERSED it’s prior position of not paying commissions on the Medicare Supplement Disabled people and will be paying the same rate of commissions that it does for 80+ applicants. Mutual of Omaha also pays commission on their less than 65 disabled policies, but at a diminished rate (of over 65+ policies).

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