Oregon – Updated Regulation and Process Update

[Northeast Agent]

Humana Medicare

The state of Oregon has amended their Medicare Supplement regulations to include revised and new Oregon Guaranteed Issue and Open Enrollment scenarios. Effective immediately the following will apply:

Guaranteed Issue

• Applicant has a guaranteed issue period if the individual joined a Medicare Advantage plan or a PACE program within six months after becoming enrolled in Medicare Part B and disenrolls no later than 12 months after joining such plan or program. This change extends the standard federal GI period.
• Applicant has a guaranteed issue period when the applicant lost or is losing Tricare as described in Title XVII of the Social Security Act. The GI period begins on the later of (1) the date the individual receives notice of termination (if notice is not received a notice that a claim has been denied due to termination) or (2) the date the coverage terms or ceases; and ends 63 days thereafter. The same plans available as if losing employer group coverage applies.

Open Enrollment Period

• Applicant has an open enrollment period if they were eligible for Medicare prior to age 65 due to disability and moved to Oregon from a state that does not require Medicare Supplement plans to be offered to those under age 65. They must enroll within 63 days of establishing Oregon residency.

Effective immediately paper applications should be submitted for the state of Oregon if the applicant is qualifying for one of the guaranteed issue or OEP rights as stated above. Humana is in the process of updating and revising the Oregon application to include new questions for above scenarios and will be provided to the market and updated in the sales kits once approved by the state of Oregon.