State RegulationsNY specificDifficulty 2/5
A Buffalo beneficiary enrolled in Medicare Part B several years ago and has been treated for a heart condition since then. She now applies for a Medicare supplement policy in New York. The insurer must:
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Answer & full 3-part explanation (select an option above, or peek)
Why C is correct
Under Reg 193 (11 NYCRR Part 58) and 11 NYCRR 360.4(h), a New York Medicare supplement applicant may enroll at any time of year, and during open enrollment the insurer may not deny issuance or charge more because of the applicant's health or claims history. A heart condition treated after Part B enrollment is not a lawful ground for refusal or a rating; that protection is what distinguishes New York from states that follow only the one-time federal window.
Why the other options are wrong
- A) The closed federal window is the trap that catches applicants in other states; under New York's year-round rule there is no deadline to have missed.
- B) Rating up for health during open enrollment is exactly what the New York rule forbids; the premium cannot reflect her heart condition.
- D) No insurability waiting period applies; the year-round open enrollment right is immediate.
Memory hook
In New York, 'too late and too sick' is never the Medigap answer.