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State RegulationsOH specificDifficulty 1/5

For an Ohio Medicare supplement policy, what is the maximum period following the effective date during which benefits may be excluded because of a preexisting condition?

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

Why C is correct

ORC 3923.332(B) and OAC 3901-8-08(N)(3) cap the preexisting-condition exclusion for Medicare supplement policies: benefits may not be excluded or limited for losses incurred more than 6 months from the effective date of coverage. The same authorities also constrain how 'preexisting condition' itself may be defined, tying the lookback to medical advice or treatment within 6 months before the effective date. An exclusion window of any greater length is unenforceable in Ohio.

Why the other options are wrong

  • A) A 3-month cap understates the statute; Ohio permits an exclusion of up to 6 months from the effective date.
  • B) The 63-day window applies to guaranteed-issue enrollment rights, not to the preexisting-condition exclusion period.
  • D) A 12-month exclusion exceeds the Ohio maximum for Medicare supplement policies.

Memory hook

Med supp pre-x exclusion tops out at 6 months from day one.

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