State RegulationsOH specificDifficulty 3/5
Under Ohio's Medicare supplement rules, how do periods of prior creditable coverage affect preexisting-condition exclusions?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
OAC 3901-8-08(N)(2) coordinates prior coverage with preexisting-condition exclusions: creditable coverage of at least 6 months eliminates preexisting-condition exclusions altogether, and a shorter period of creditable coverage reduces the exclusion period accordingly. This protects applicants moving between plans from being subjected repeatedly to the same 6-month exclusion, while still allowing the issuer to apply a proportionate exclusion when the prior coverage was brief. The rule operates outside the open-enrollment window, where exclusions may otherwise be imposed.
Why the other options are wrong
- B) The full elimination benefit requires at least 6 months of creditable coverage; a brief period only reduces, not eliminates, the exclusion.
- C) Creditable coverage does matter — the rule requires offset of the exclusion period by the prior coverage, at least in reduced form.
- D) No health screening condition appears in the rule; the offset turns on the length of prior creditable coverage alone.
Memory hook
Six months of prior coverage wipes out Med supp pre-x; less coverage shrinks it.