STATE HOUSE – Sen. Valarie Lawson has introduced legislation to protect seniors from being denied supplemental Medicare coverage or charged higher rates based on pre-existing conditions.

“Our seniors worked their whole lives and should now be able to access the health care they need,” said Senator Lawson (D-Dist. 14, East Providence). “Profitable companies shouldn’t be denying people coverage based on health issues outside of their control. It’s just wrong.”

Most individuals over 65 years old are eligible to enroll in Medicare, a health insurance plan from the federal government. Medicare has four parts, A, B, C and D.

Medicare Part A covers hospitalizations and some other inpatient services. Medicare Part B covers doctors’ visits and some other outpatient services. Both are administered directly by the federal government and include costs such as deductibles, copays and coinsurance.

Medicare supplement plans, also known as Medigap, are sold by private companies to cover costs that Medicare Parts A and B do not cover such as copays, coinsurance and deductibles. Seniors who wish to enroll in Medigap coverage must do so during an initial open enrollment period (when they first become eligible for Medicare) or after a qualifying life event such as a move or loss of a job. Seniors wishing to make changes later on may be subject to a complex underwriting process including health screenings and blood work. Seniors can be denied due to pre-existing conditions.

The bill (2023-S 0583) would prohibit insurers from subjecting seniors to this underwriting process, denying them coverage or charging higher rates due to pre-existing conditions. Other states, including Massachusetts and Connecticut, have similar legislation.

“We make our health care system too complicated for anyone to understand,” said Senator Lawson. “This bill would enable seniors to choose the plan that’s right for them without facing discrimination, so they can get the care they need.”