State RegulationsGA specificDifficulty 2/5
A Medicare supplement policy delivered in Georgia defines the term preexisting condition. Under Georgia law, how restrictive may that definition be?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
Under O.C.G.A. § 33-43-3(b), a Medicare supplement policy may not define preexisting condition more restrictively than one for which medical advice, diagnosis, care, or treatment was recommended or received within six months before the effective date of coverage. Any broader definition is prohibited by the statute.
Why the other options are wrong
- B) The definition must be tied to advice or treatment in the statutory look-back window, not to anything left off the application.
- C) A definition reaching all prior diagnoses is more restrictive than Georgia permits for med supp policies.
- D) A five-year look-back exceeds the six-month window the statute allows.
Memory hook
Medigap preexisting looks back only six months for advice or treatment.