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State RegulationsGA specificDifficulty 2/5

A Georgia Medicare supplement policy is issued with a preexisting-condition exclusion. Under Georgia law, a preexisting condition may not be defined more restrictively than one for which the applicant received medical advice or treatment within what period before the policy's effective date?

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Answer & full 3-part explanation (select an option above, or peek)

Why D is correct

Under O.C.G.A. § 33-43-3(b), a Medicare supplement policy may not exclude losses incurred more than 6 months after the effective date, and the term 'preexisting condition' may not be defined more restrictively than a condition for which medical advice or treatment was recommended or received within the 6 months before the effective date. This statutory cap limits how far back a Medigap insurer may look when denying claims, protecting Medicare-eligible applicants from open-ended look-back windows.

Why the other options are wrong

  • A) 2 years is Georgia's incontestability window for life policies; the Medigap preexisting definition window is capped at 6 months under O.C.G.A. § 33-43-3(b).
  • B) 5 years is far longer than the statute allows; Georgia limits the Medigap preexisting look-back to 6 months before the effective date.
  • C) 1 year doubles the statutory window; the permissible look-back for defining a preexisting condition is only 6 months under O.C.G.A. § 33-43-3(b).

Memory hook

Medigap looks back only half a year: six months, then no further.

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