Short title

This Act may be cited as the

Equal Access to Medicare Options Act of 2012

Guaranteed issue of Medigap policies to all Medicare beneficiaries

(a)

In general

Section 1882(s) of the Social Security Act (42 U.S.C. 1395ss(s)) is amended— (1)in paragraph (2)(A), by striking 65 years of age or older and is enrolled for benefits under part B and inserting entitled to, or enrolled for, benefits under part A and enrolled for benefits under part B; (2)in paragraph (2)(D), by striking who is 65 years of age or older as of the date of issuance and; and (3)in paragraph (3)(B)(vi), by striking at age 65. (b)

Effective date; phase-In authority

(1)

Effective date

Subject to paragraph (2), the amendments made by subsection (a) shall apply to Medicare supplemental policies effective on or after January 1, 2014. (2)

Phase-in authority

(A)

In general

Subject to subparagraph (B), the Secretary of Health and Human Services may phase in the implementation of the amendments made under subsection (a) in such manner as the Secretary determines appropriate in order to minimize any adverse impact on individuals enrolled under a Medicare supplemental policy prior to January 1, 2014. (B)

Phase-in period may not exceed 5 years

The Secretary of Health and Human Services shall ensure that the amendments made by subsection (a) are fully implemented by not later than January 1, 2019. (c)

Separate premium class

(1)

In general

Subject to paragraph (2), any individuals enrolled under a Medicare supplemental policy pursuant to the amendments made under subsection (a) shall be classified by the issuer as part of a separate premium class. (2)

Limit

The provision in paragraph (1) shall apply to individuals that enroll under a Medicare supplemental policy prior to January 1, 2019. (d)

Additional enrollment period for certain individuals

(1)

One-time enrollment period

(A)

In general

In the case of an individual described in paragraph (2), the Secretary shall establish a one-time enrollment period during which such an individual may enroll in any Medicare supplemental policy of the individual's choosing. (B)

Period

The enrollment period established under subparagraph (A) shall begin on the date on which the phase-in period under subsection (b) is completed and end 6 months after such date. (2)

Individual described

An individual described in this paragraph is an individual who— (A)is entitled to hospital insurance benefits under part A under section 226(b) or section 226A of the Social Security Act (42 U.S.C. 426(b); 426–1); (B)is enrolled for benefits under part B of such Act (42 U.S.C. 1395j et seq.); and (C)would not, but for the provisions of and amendments made by this section, be eligible for the guaranteed issue of a Medicare supplemental policy under section 1882(s)(2) of such Act (42 U.S.C. 1395ss(s)(2)). (3)

Outreach plan

The Secretary shall develop an outreach plan to notify individuals described in paragraph (2) of the one-time enrollment period established under paragraph (1).

Guaranteed issue of Medigap policies for Medicare Advantage and Medicaid enrollees

(a)

In general

Section 1882(s)(3) of the Social Security Act (42 U.S.C. 1395ss(s)(3)), as amended by section 2, is amended— (1)in subparagraph (B), by adding at the end the following new clauses:

(vii)The individual was enrolled in a Medicare Advantage plan under part C for not less than 12 months and subsequently disenrolled from such plan and elects to receive benefits under this title through the original Medicare fee-for-service program under parts A and B. (viii)The individual— (I)is entitled to, or enrolled for, benefits under part A and enrolled for benefits under part B; (II)was eligible for medical assistance under a State plan or waiver under title XIX and was enrolled in such plan or waiver; and (III)subsequently lost eligibility for such medical assistance.

;

(2)by striking subparagraph (C)(iii) and inserting the following:

(iii)Subject to subsection (v)(1), for purposes of an individual described in clause (vi), (vii), or (viii) of subparagraph (B), a Medicare supplemental policy described in this subparagraph shall include any Medicare supplemental policy.

; and

(3)in subparagraph (E)— (A)in clause (iv), by striking and at the end; (B)in clause (v), by striking the period at the end and inserting a semicolon; and (C)by adding at the end the following new clauses—

(vi)in the case of an individual described in subparagraph (B)(vii), the annual, coordinated election period (as defined in section 1851(e)(3)(B)) or a continuous open enrollment period (as defined in section 1851(e)(2)) during which the individual disenrolls from a Medicare Advantage plan under part C; and (vii)in the case of an individual described in subparagraph (B)(viii), the period beginning on the date that the individual receives a notice of cessation of such individual's eligibility for medical assistance under the State plan or waiver under title XIX and ending on the date that is 123 days after the individual receives such notice.

(b)

Effective date

The amendments made by subsection (a) shall apply to Medicare supplemental policies effective on or after January 1, 2014.

Enrollment of individuals with end stage renal disease in Medicare Advantage

(a)

In general

Section 1851(a) of the Social Security Act (42 U.S.C. 1395w–21(a)) is amended by striking paragraph (3) and inserting the following:

(3)

Medicare Advantage eligible individual

In this title, the term Medicare Advantage eligible individual means an individual who is entitled to benefits under part A and enrolled under part B.

(b)

Conforming amendments

(1)Section 1852(b) of the Social Security Act (42 U.S.C. 1395w–22(b)) is amended by striking paragraph (1) and inserting the following:

(1)

Beneficiaries

A Medicare Advantage organization may not deny, limit, or condition the coverage or provision of benefits under this part, for individuals permitted to be enrolled with the organization under this part, based on any health status-related factor described in section 2702(a)(1) of the Public Health Service Act. The Secretary shall not approve a plan of an organization if the Secretary determines that the design of the plan and its benefits are likely to substantially discourage enrollment by certain MA eligible individuals with the organization.

(2)Section 1859(b)(6)(B) of such Act (42 U.S.C. 1395w–28(b)(6)(B)) is amended in the second sentence by striking may waive application of section 1851(a)(3)(B) in the case of an individual described in clause (i), (ii), or (iii) of this subparagraph and. (c)

Effective date

The amendments made by this section shall apply to plan years beginning on or after January 1, 2014.