A Medicare supplement policy is issued in Georgia. Which statement correctly states the law on preexisting-condition restrictions in Medigap policies?

Why D is correct

Under O.C.G.A. § 33-43-3(b), a Medicare supplement policy may not exclude losses incurred more than six months after the effective date of coverage on the ground that a condition existed before the policy was issued, and 'preexisting condition' may not be defined more restrictively than a condition for which medical advice was given or treatment was recommended or received within six months before the effective date.

Why the other options are wrong

• A) Exclusions of losses incurred more than six months after the effective date are prohibited regardless of treatment history.
• B) A twelve-month look-back is more restrictive than the statute allows; the ceiling is six months before the effective date.
• C) Two years belongs to the A&S time-limit-on-defenses rule under O.C.G.A. § 33-29-3(b)(2)(A), not to Medigap preexisting-condition limits.

Memory hook

Medigap looks back six months, no further.