HB2516

The Chris Larkin ALS Act requires an issuer that offers Medicare supplement coverage to people 65 and older to offer the same coverage to people under 65 who are eligible for and enrolled in Medicare because of end-stage renal disease or amyotrophic lateral sclerosis (ALS). The final law does not extend this particular new protection to every person under 65 who qualifies for Medicare because of another disability. It concerns Medicare supplement insurance, often called Medigap, not a new state payment of Medicare premiums. Final law, Sections 1–2.

The law sets two pricing rules. Standardized Medigap Plans A, B and D must be offered at the same premium rate charged to a 65-year-old. Other offered Medigap plans may cost no more than 200% of the rate charged to a 65-year-old for the same plan—twice that rate, not three times it. These Medigap plan letters are not Medicare Parts A, B and D. The act does not require an insurer to introduce every standardized plan or make coverage free. Final law, new Insurance Code 1652.059.

An eligible person has a six-month enrollment period beginning on the first day of the first month they become enrolled in Medicare Part B. During the protected enrollment period, the issuer cannot deny or condition issuance of an available plan, use medical underwriting or health-based price discrimination, impose a waiting period, or limit or exclude benefits because of a preexisting condition. The commissioner must adopt implementing rules, including rules designating enrollment periods. The protection is not a statement that every application at any time must be accepted. Final law, new Insurance Code 1652.060.

For people already under 65 and enrolled in Part B because of ALS or end-stage renal disease on June 20, 2025, the act also created a transitional application window, stated as “after December 1, 2025, and before June 1, 2026.” If a person requested an application during that period but could not apply because the application was unavailable, the statute instead allows six months from when the application first becomes available. The ordinary transitional window is now past; this is not a promise that it remains open indefinitely. The delayed-application provision and other applicable enrollment periods must be considered separately. Final law, Section 4.

The act became effective immediately on June 20, 2025, but its changes apply to supplement plans delivered, issued for delivery or renewed on or after September 1, 2025. In its implementation bulletin, the Texas Department of Insurance said carriers need not automatically change existing enrollees’ rates without a new application and encouraged notification of the new opportunity. The bulletin’s shorthand should not replace the enacted premium ceiling or exact statutory dates quoted above. Final law, Sections 3–5; official history; TDI implementation bulletin.