Key Takeaways
- Illinois requires a 30-day free look period for Medicare Supplement policies
- Illinois provides a 6-month open enrollment period starting at age 65 with Part B
- Guaranteed issue rights apply when losing other coverage or during open enrollment
- Illinois prohibits pre-existing condition waiting periods during open enrollment
- Medicare Supplement plans must be standardized (Plans A through N)
Illinois Medicare Supplement (Medigap) Regulations
Illinois provides important protections for Medicare beneficiaries purchasing Medicare Supplement (Medigap) insurance.
Free Look Period
Illinois requires a 30-day free look period for Medicare Supplement policies:
- Policyholder can return for full premium refund
- Begins when policy is delivered
- Applies to all Medicare Supplement plans
- No questions asked, no penalty
Exam Tip: Medicare Supplement has a 30-day free look in Illinois, which is longer than the 10-day free look for standard health insurance.
Open Enrollment Period
Illinois provides a 6-month open enrollment period for Medicare Supplement:
When It Begins
The 6-month period starts:
- First day of the month you are 65 or older AND
- Enrolled in Medicare Part B
Protections During Open Enrollment
- Guaranteed issue - Must be accepted regardless of health
- No pre-existing condition exclusions
- Standard rates - Cannot be charged more for health conditions
- Any plan available - Can choose any Medigap plan A through N
Outside Open Enrollment
If you apply outside the 6-month open enrollment period:
- Insurers can use medical underwriting
- May deny coverage based on health
- May impose pre-existing condition waiting periods
- May charge higher premiums based on health
Exception: Guaranteed Issue Rights
You have guaranteed issue rights in specific situations even outside open enrollment.
Guaranteed Issue Rights
Beyond open enrollment, Illinois provides guaranteed issue rights in specific situations:
Triggering Events
| Event | Guaranteed Issue Right |
|---|---|
| Losing employer coverage | Can purchase Medigap within 63 days |
| Leaving Medicare Advantage | Can purchase Medigap within 63 days |
| Medicare Advantage plan leaves area | Can purchase Medigap |
| Medigap insurer becomes insolvent | Can switch to comparable plan |
| Losing Medicaid | Can purchase Medigap |
Trial Right
If you leave Medigap for Medicare Advantage:
- Have 12 months to decide
- Can return to previous Medigap plan or comparable plan
- Guaranteed issue, no health questions
- Only applies to first 12 months
Standardized Plans
Illinois requires Medigap plans to be standardized:
Available Plans
| Plan | Benefits |
|---|---|
| Plan A | Basic benefits only |
| Plan B | Basic + Part A deductible |
| Plan C | Comprehensive (pre-2020 only) |
| Plan D | Similar to C, no Part B excess |
| Plan F | Most comprehensive (pre-2020 only) |
| Plan G | Like F without Part B deductible |
| Plan K | 50% cost sharing, out-of-pocket max |
| Plan L | 75% cost sharing, out-of-pocket max |
| Plan M | 50% Part A deductible |
| Plan N | Cost sharing, copays for visits |
Note: Plans C and F are only available to those eligible for Medicare before January 1, 2020.
Rate Regulation
Illinois allows several rating methods:
- Attained age rating (premiums increase with age)
- Issue age rating (premium based on age at purchase)
- Community rating (same premium regardless of age)
- Rate increases must be filed with IDOI
How long is the free look period for Medicare Supplement policies in Illinois?
When does the 6-month Medicare Supplement open enrollment period begin in Illinois?