89R26499 SCF-D
By: Guillen, Dean, Wharton, Johnson, Buckley, H.B. No. 2516
et al.
Substitute the following for H.B. No. 2516:
By: Dean C.S.H.B. No. 2516
A BILL TO BE ENTITLED
AN ACT
relating to the eligibility of certain individuals younger than 65
years of age to purchase Medicare supplement benefit plans.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter B, Chapter 1652, Insurance Code, is
amended by adding Sections 1652.059 and 1652.060 to read as
follows:
Sec. 1652.059. COVERAGE FOR CERTAIN INDIVIDUALS YOUNGER
THAN 65. (a) In this section, "entity" means an entity that
delivers or issues for delivery a Medicare supplement benefit plan
in this state.
(b) An entity that offers coverage under a Medicare
supplement benefit plan to individuals 65 years of age or older must
offer the same coverage to individuals younger than 65 years of age
who are eligible for and enrolled in Medicare by reason of
disability, end stage renal disease, or amyotrophic lateral
sclerosis.
(c) Except as otherwise provided by rules adopted under
Section 1652.051, any benefit, protection, policy, or procedure
applicable to coverage under a plan for an individual 65 years of
age or older must apply to coverage offered under Subsection (b).
(d) A standardized Plan A, Plan B, or Plan D Medicare
supplement benefit plan offered under Subsection (b) must be
offered at the same premium rate charged for the plan to an
individual 65 years of age. A premium rate for a Medicare
supplement benefit plan offered under Subsection (b), other than
Plan A, Plan B, or Plan D, may not exceed 200 percent of the premium
rate charged for the same plan to an individual 65 years of age.
Sec. 1652.060. ENROLLMENT PERIOD FOR CERTAIN INDIVIDUALS
YOUNGER THAN 65. (a) In this section, "entity" means an entity
that delivers or issues for delivery a Medicare supplement benefit
plan in this state.
(b) An individual eligible for coverage under a Medicare
supplement benefit plan under Section 1652.059 may enroll any time
during the six-month period beginning the first day of the first
month the individual becomes enrolled for benefits under Medicare
Part B.
(c) During an enrollment period, an entity may not, with
respect to an applicant who is an individual described by
Subsection (b):
(1) deny or condition the issuance or effectiveness of
a Medicare supplement benefit plan or certificate that the entity
offers and is available for issuance in this state;
(2) subject the applicant to medical underwriting or
discriminate in the price of a Medicare supplement benefit plan or
certificate because of the applicant's health status, claims
experience, receipt of health care, or medical condition;
(3) impose a waiting period; or
(4) impose a limitation or exclusion of benefits based
on the applicant's preexisting condition.
(d) The commissioner shall adopt rules as necessary to
administer this section, including rules designating enrollment
periods.
SECTION 2. The changes in law made by this Act apply only to
a Medicare supplement benefit plan delivered, issued for delivery,
or renewed on or after September 1, 2025.
SECTION 3. In addition to other enrollment periods provided
by law, an individual younger than 65 years of age and enrolled in
Medicare Part B by reason of disability, end stage renal disease, or
amyotrophic lateral sclerosis on the effective date of this Act may
apply for coverage under a Medicare supplement benefit plan:
(1) after August 31, 2025, and before March 2, 2026; or
(2) if the individual is unable to submit an
application for coverage under the plan during the period described
by Subdivision (1) of this section because the application is not
available and the individual requested the application during that
period, during a six-month period beginning on the date the
application initially becomes available.
SECTION 4. This Act takes effect September 1, 2025.