18 Del. Admin. Code § 1501-14.0
Current through Register Vol. 28, No. 5, November 1, 2024
Section 1501-14.0 - Open Enrollment14.1 An issuer shall not deny or condition the issuance or effectiveness of any Medicare supplement policy or certificate available for sale in this state, nor discriminate in the pricing of a policy or certificate because of the health status, claims experience, receipt of health care, or medical condition of an applicant in the case of an application for a policy or certificate that is submitted prior to or during the six (6) month period beginning with the first day of the first month in which an individual is both 65 years of age or older and is enrolled for benefits under Medicare Part B. Each Medicare supplement policy and certificate currently available from an insurer shall be made available to all applicants who qualify under this subsection without regard to age.14.2 Credible coverage and pre-existing conditions14.2.1 If an applicant qualifies under subsection 14.1 of this regulation and submits an application during the time period referenced in subsection 14.1 of this regulation and, as of the date of application, has had a continuous period of creditable coverage of at least six (6) months, the issuer shall not exclude benefits based on a preexisting condition.14.2.2 If the applicant qualifies under subsection 14.1 of this regulation and submits an application during the time period referenced in subsection 14.1 of this regulation and, as of the date of application, has had a continuous period of creditable coverage that is less than six (6) months, the issuer shall reduce the period of any preexisting condition exclusion by the aggregate of the period of creditable coverage applicable to the applicant as of the enrollment date. The Secretary shall specify the manner of the reduction under this subsection.14.3 Except as provided in subsection 14.2 and Sections 15.0 and 26.0 of this regulation, subsection 14.1 of this regulation shall not be construed as preventing the exclusion of benefits under a policy, during the first six (6) months, based on a preexisting condition for which the policyholder or certificate holder received treatment or was otherwise diagnosed during the six (6) months before the coverage became effective.18 Del. Admin. Code § 1501-14.0
22 DE Reg. 1026 (6/1/2019) (final)