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A BILL TO BE ENTITLED
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AN ACT
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relating to the eligibility of certain individuals younger than 65 |
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years of age to purchase Medicare supplement benefit plans. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter B, Chapter 1652, Insurance Code, is |
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amended by adding Sections 1652.059 and 1652.060 to read as |
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follows: |
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Sec. 1652.059. COVERAGE FOR CERTAIN INDIVIDUALS YOUNGER |
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THAN 65. (a) In this section, "entity" means an entity that |
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delivers or issues for delivery a Medicare supplement benefit plan |
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in this state. |
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(b) An entity that offers coverage under a Medicare |
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supplement benefit plan to individuals 65 years of age or older must |
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offer the same coverage to individuals younger than 65 years of age |
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who are eligible for and enrolled in Medicare by reason of |
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disability or end stage renal disease. |
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(c) Except as otherwise provided by rules adopted under |
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Section 1652.051, any benefit, protection, policy, or procedure |
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applicable to coverage under a plan for an individual 65 years of |
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age or older must apply to coverage offered under Subsection (b). |
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(d) An entity shall offer a plan under Subsection (b) at the |
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same premium rate charged for that plan to an individual 65 years of |
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age. |
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Sec. 1652.060. OPEN AND SPECIAL ENROLLMENT PERIODS FOR |
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CERTAIN INDIVIDUALS YOUNGER THAN 65. (a) In this section, "entity" |
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means an entity that delivers or issues for delivery a Medicare |
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supplement benefit plan in this state. |
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(b) An individual eligible for coverage under a Medicare |
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supplement benefit plan under Section 1652.059 may enroll any time |
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during: |
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(1) the six-month period beginning the first day of |
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the first month the individual becomes enrolled for benefits under |
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Medicare Part B; |
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(2) a 60-day open enrollment period each year |
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beginning on the date of the individual's birth; or |
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(3) a special enrollment period designated by the |
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commissioner. |
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(c) During an enrollment period, an entity may not: |
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(1) deny or condition the issuance or effectiveness of |
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a Medicare supplement benefit plan or certificate that the entity |
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offers and is available for issuance in this state; |
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(2) subject an applicant to medical underwriting or |
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discriminate in the price of a Medicare supplement benefit plan or |
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certificate because of the applicant's health status, claims |
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experience, receipt of health care, or medical condition; or |
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(3) impose an exclusion of benefits based on an |
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applicant's preexisting condition. |
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(d) The commissioner shall adopt rules as necessary to |
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administer this section, including rules designating enrollment |
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periods. |
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SECTION 2. The changes in law made by this Act apply only to |
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a Medicare supplement benefit plan delivered, issued for delivery, |
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or renewed on or after September 1, 2025. |
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SECTION 3. In addition to other enrollment periods provided |
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by law, an individual younger than 65 years of age and enrolled in |
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Medicare Part B by reason of disability or end stage renal disease |
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on the effective date of this Act may apply for coverage under a |
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Medicare supplement benefit plan: |
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(1) after August 31, 2025, and before March 2, 2026; or |
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(2) if the individual is unable to submit an |
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application for coverage under the plan during the period described |
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by Subdivision (1) of this section because the application is not |
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available and the individual requested the application during that |
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period, during a six-month period beginning on the date the |
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application initially becomes available. |
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SECTION 4. This Act takes effect September 1, 2025. |