Kansas Insurance Department

 

K.A.R. 40-4-29a. Same; renewability of individual hospital, medical, or surgical expense policy. (a) Except as specifically authorized by K.S.A. 40-2257(b) and amendments thereto, an insurer shall not terminate an individual hospital, medical, or surgical expense policy for any insured who is eligible for Medicare if the insured wishes to continue the individual’s coverage.

(b)               Each insurer shall mail to its current individual medical policyholders approaching the age of 65 or Medicare eligibility explaining, in detail, the options available to them.  The following notice shall be provided:

“IMPORTANT CONSUMER NOTICE

From Sandy Praeger, Commissioner of Insurance, State of Kansas

Dear Fellow Kansan,

 

            Under the Federal Health Insurance Portability and Accountability Act and Kansas Statutes Annotated §40-2257, persons covered under an individual hospital, medical, or surgical expense policy may continue to renew this coverage even when they become eligible for Medicare.  This means you may either:

·        continue your current individual coverage into the future as long as

 

you continue to pay premiums, or

 

·        purchase a policy specifically designed to complement Medicare benefits, known as a Medicare supplement policy, once you are eligible for Medicare, or

 

·        continue your current individual coverage and purchase a Medicare supplement policy.

            The reason I am providing you with this information is to stress the importance of the decision you need to make.  Each person who becomes enrolled for benefits in Medicare Part B receives an open enrollment period of six (6) months.  During this six-month period, a person who applies for a Medicare supplement policy cannot be turned down and a policy will be issued to the applicant (subject to pre-existing condition limitations for some companies) without medical underwriting.

            However, if you choose to maintain your current individual hospital, medical, or surgical policy after becoming enrolled in Medicare Part B, your six-month open enrollment period still begins to run.  In general, this means that if you decide to apply for a Medicare supplement policy after the six-month period has passed, an insurance company may legally require you to meet its medical underwriting standards before issuing you such a policy.

            You should also know that if you maintain your current individual policy and/or purchase a Medicare supplement policy, your premiums may increase as you get older.  Neither policy will provide benefits that duplicate those provided by Medicare.  In addition, although your current individual hospital, medical, or surgical expense policy may provide greater benefits than those offered through a Medicare supplement policy, you will likely be charged a greater premium rate and, in the long run, probably pay more for an individual hospital, medical, or surgical expense policy than a Medicare supplement policy.  This is an important point to note and you should carefully compare and consider the cost of your current coverage and the benefits it provides, to the cost of a Medicare supplement policy and the benefits it provides.

            Under the Federal Health Insurance Portability and Accountability Act and Kansas Statutes Annotated 40-2257, persons covered under an individual hospital, medical, or surgical expense policy may continue to renew this coverage, even when they become eligible for Medicare, except under very limited circumstances, such as when an insurer provides advance notice it is altogether ceasing to offer individual polices.

            If you have any questions about your current coverage or purchasing a Medicare supplement policy, you may contact the Consumer Assistance Division of the Kansas Insurance Department at 1-800-432-2484 and one of our representatives will be glad to assist you.

Sandy Praeger

Commissioner of Insurance”

 

(Authorized by K.S.A. 40-103 and 40-2257(i); implementing K.S.A. 40-2257; effective January 12, 2007.)