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?
Which Medigap plans are only available to those eligible for Medicare before January 1, 2020?
What rating methods does Illinois allow for Medicare Supplement policies?