Certification of Medicare supplemental (Medigap) policies

What this document is

42 U.S.C. s. 1395ss: Certification of Medicare supplemental (Medigap) policies is a state statute published by U.S. Government Publishing Office (govinfo.gov). It is one of the documents that insurance license exam questions are written from, including life & health practice questions. This page summarizes it and points to the official version, which is the text to rely on.

Sections cited in practice questions

Each practice answer shows the exact passage it comes from. These are sections of this document that questions cite, with a short excerpt from the source text.

• 42 U.S.C. § 1395ss: subsection (s)(2) (Guaranteed Issue at Open Enrollment; Pre-existing Condition Limits)

  “(2)(A) The issuer of a medicare supplemental policy may not deny or condition the issuance or effectiveness of a medicare supplemental policy, or discriminate in the pricing of the policy, because of health status, claims experience, receipt of health care, or medical condition in the case of an...”

• 42 U.S.C. § 1395ss: subsection (p)(2)(B) (Standardized Benefit Packages)

  “(A) for such groups or packages of benefits as may be appropriate taking into account the considerations specified in paragraph (3) and the requirements of the succeeding subparagraphs; (B) for identification of a core group of basic benefits common to all policies; and (C) that, subject to...”

• 42 U.S.C. § 1395ss(d)(3)(B)(iii)(II) - replacement exception to the prohibition on selling duplicate Medigap coverage

  “(II) Subclause (I) shall not apply in the case of an individual who has a medicare supplemental policy, if the individual indicates in writing, as part of the application for purchase, that the policy being purchased replaces such other policy and indicates an intent to terminate the policy being...”

Practice this material

Questions about this source

More Federal sources sources

• Coverage for Pre-existing Conditions (Affordable Care Act) - HealthCare.govFederal guidance
• 20 C.F.R. § 404.1520 -- Evaluation of Disability in General (the five-step sequential evaluation process)Regulation
• Parts of Medicare (Medicare & You / medicare.gov)Federal guidance
• Continuation of Health Coverage (COBRA) - U.S. Department of LaborReference
• Portability of Health Coverage (HIPAA) - U.S. Department of LaborReference
• Fair Credit Reporting Act - 15 U.S.C. § 1681a (Definitions)State statute
• 15 U.S.C. s. 1681b: FCRA permissible purposes of consumer reportsState statute
• 15 U.S.C. s. 1681c: FCRA requirements relating to obsolete information in consumer reportsState statute