Ga. Comp. R. & Regs. R. 120-2-8-.11 - Open Enrollment
(1) An issuer shall not deny or condition the
issuance or effectiveness of any Medicare supplement policy or certificate
available for sale in this state, nor discriminate in the pricing of a policy
or certificate because of the health status, claims experience, receipt of
health care, or medical condition of an applicant in the case of an application
for a policy or certificate that is submitted prior to or during the six (6)
month period beginning with the first day of the first month in which an
individual is both 65 years of age or older and is enrolled for benefits under
Medicare Part B. Each Medicare supplement policy and certificate currently
available from an insurer shall be made available to all applicants who qualify
under this subsection.
(2)
(a) If an applicant qualifies under
Subsection (1) and submits an application during the time period referenced in
Subsection (1) and, as of the date of application, has had a continuous period
of creditable coverage of at least six (6) months, the issuer shall not exclude
benefits based on a preexisting condition.
(b) If the applicant qualifies under
Subsection (1) and submits an application during the time period referenced in
Subsection (1) and, as of the date of application, has had a continuous period
of creditable coverage that is less than six (6) months, the issuer shall
reduce the period of any preexisting condition exclusion by the aggregate of
the period of creditable coverage applicable to the applicant as of the
enrollment date. The Secretary shall specify the manner of the reduction under
this subsection.
(3)
Except as provided in Subsection (2) and Sections
120-2-8-.12 and
120-2-8-.23, Subsection (1) shall
not be construed as preventing the exclusion of benefits under a policy, during
the first six (6) months, based on a preexisting condition for which the
policyholder or certificateholder received treatment or was otherwise diagnosed
during the six (6) months before the coverage became effective.
Notes
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