I 
117TH CONGRESS 
1ST SESSION 
H. R. 599 
To amend title XVIII of the Social Security Act to provide for the guaranteed 
issue of Medigap policies to all Medigap-eligible Medicare beneficiaries 
and Medicare Advantage enrollees, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JANUARY 28, 2021 
Mr. SCHNEIDER introduced the following bill; which was referred to the Com-
mittee on Ways and Means, and in addition to the Committee on Energy 
and Commerce, for a period to be subsequently determined by the Speak-
er, in each case for consideration of such provisions as fall within the ju-
risdiction of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to provide 
for the guaranteed issue of Medigap policies to all 
Medigap-eligible Medicare beneficiaries and Medicare Ad-
vantage enrollees, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Protecting Medicare 
Beneficiaries with Pre-Existing Conditions Act’’. 
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SEC. 2. GUARANTEED ISSUE. 
(a) GUARANTEED ISSUE OF MEDIGAP POLICIES TO 
ALL MEDIGAP-ELIGIBLE MEDICARE BENEFICIARIES.— 
(1) IN GENERAL.—Section 1882(s) of the So-
cial Security Act (42 U.S.C. 1395ss(s)) is amend-
ed— 
(A) 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 en-
rolled for, benefits under part A and enrolled 
for benefits under part B’’; 
(B) in paragraph (2)(D), by striking ‘‘who 
is 65 years of age or older as of the date of 
issuance and’’; 
(C) in paragraph (3)(B)(ii), by striking ‘‘is 
65 years of age or older and’’; and 
(D) in paragraph (3)(B)(vi), by striking 
‘‘at age 65’’. 
(2) EFFECTIVE DATE; PHASE-IN AUTHORITY.— 
(A) EFFECTIVE
DATE.—Subject to sub-
paragraph (B), the amendments made by para-
graph (1) shall apply to medicare supplemental 
policies effective on or after January 1, 2023. 
(B) PHASE-IN AUTHORITY.— 
(i) IN
GENERAL.—Subject to clause 
(ii), the Secretary of Health and Human 
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Services may phase in the implementation 
of the amendments made under paragraph 
(1) (with such phase-in beginning on or 
after January 1, 2023) in such manner as 
the Secretary determines appropriate in 
order to minimize any adverse impact on 
individuals enrolled under a medicare sup-
plemental policy. 
(ii) PHASE-IN PERIOD MAY NOT EX-
CEED 5 YEARS.—The Secretary of Health 
and Human Services shall ensure that the 
amendments made by paragraph (1) are 
fully implemented by not later than Janu-
ary 1, 2028. 
(3) ADDITIONAL
ENROLLMENT
PERIOD
FOR 
CERTAIN INDIVIDUALS.— 
(A) ONE-TIME ENROLLMENT PERIOD.— 
(i) IN GENERAL.—In the case of an 
individual described in subparagraph (B), 
the Secretary shall establish a one-time en-
rollment period during which such an indi-
vidual may enroll in any medicare supple-
mental policy of the individual’s choosing. 
(ii) PERIOD.—The enrollment period 
established under clause (i) shall begin on 
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the date on which the phase-in period 
under paragraph (2) is completed and end 
6 months after such date. 
(B) INDIVIDUAL
DESCRIBED.—An indi-
vidual described in this paragraph is an indi-
vidual who— 
(i) is entitled to hospital insurance 
benefits under part A of title XVIII of the 
Social Security Act (42 U.S.C. 1395c et 
seq.) pursuant to section 226(b) or section 
226A of such Act (42 U.S.C. 426(b); 426– 
1); 
(ii) is enrolled for benefits under part 
B of such Act (42 U.S.C. 1395j et seq.); 
and 
(iii) would not, but for the provisions 
of and amendments made by paragraphs 
(1) and (2), be eligible for the guaranteed 
issue of a medicare supplemental policy 
under paragraph (2) or (3) of section 
1882(s) of such Act (42 U.S.C. 1395ss(s)). 
(C) OUTREACH PLAN.— 
(i) IN GENERAL.—The Secretary shall 
develop an outreach plan to notify individ-
uals described in subparagraph (B) of the 
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one-time enrollment period established 
under subparagraph (A). 
(ii) 
CONSULTATION.—In 
imple-
menting the outreach plan developed under 
clause (i), the Secretary shall consult with 
consumer advocates, brokers, insurers, the 
National Association of Insurance Commis-
sioners, and State Health Insurance As-
sistance Programs. 
(b) GUARANTEED ISSUE OF MEDIGAP POLICIES FOR 
MEDICARE ADVANTAGE ENROLLEES.— 
(1) IN
GENERAL.—Section 1882(s)(3) of the 
Social Security Act (42 U.S.C. 1395ss(s)(3)), as 
amended by subsection (a), is further amended— 
(A) in subparagraph (B), by adding at the 
end the following new clause: 
‘‘(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.’’; 
(B) by striking subparagraph (C)(iii) and 
inserting the following: 
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‘‘(iii) Subject to subsection (v)(1), for purposes of an 
individual described in clause (vi) or (vii) of subparagraph 
(B), a medicare supplemental policy described in this sub-
paragraph shall include any medicare supplemental pol-
icy.’’; and 
(C) in subparagraph (E)— 
(i) in clause (iv), by striking ‘‘and’’ at 
the end; 
(ii) in clause (v), by striking the pe-
riod at the end and inserting ‘‘; and’’; and 
(iii) by adding at the end the fol-
lowing new clause— 
‘‘(vi) in the case of an individual described in 
subparagraph (B)(vii), the annual, coordinated elec-
tion 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.’’. 
(2) EFFECTIVE DATE.—The amendments made 
by paragraph (1) shall apply to medicare supple-
mental policies effective on or after January 1, 
2023. 
Æ 
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