Oregon adopts new Medicare supplement insurance policies effective January 2026

Oregon's Senate Bill 1181 aims to enhance protections for Medicare beneficiaries by addressing preexisting condition exclusions in Medicare supplement insurance policies. Introduced on February 27, 2025, the bill seeks to ensure that insurers cannot deny coverage or impose restrictive terms based on an individual's health status, geographic location, or age.

Key provisions of SB 1181 include a prohibition on denying claims for losses incurred more than six months from the effective date of coverage for preexisting conditions. The bill also mandates that insurers cannot define preexisting conditions more restrictively than conditions for which medical advice was given or treatment was received within six months prior to coverage. This change is designed to provide greater access to necessary healthcare for seniors, who often face challenges in obtaining affordable insurance due to their medical histories.

The bill has sparked notable discussions among lawmakers and stakeholders, particularly regarding its potential impact on insurance premiums and the overall healthcare market. Supporters argue that the legislation will promote fairness and accessibility for older adults, while opponents express concerns about the financial implications for insurance providers, fearing that increased coverage requirements could lead to higher premiums for all policyholders.

If passed, SB 1181 will apply to insurance policies issued, renewed, or extended starting January 1, 2026. The implications of this bill could be significant, as it not only aims to protect vulnerable populations but also sets a precedent for how insurance companies handle preexisting conditions in the future. Experts suggest that the bill could lead to a more equitable healthcare landscape for seniors in Oregon, potentially influencing similar legislative efforts in other states.

As the legislative process unfolds, the outcome of SB 1181 will be closely monitored by advocates and opponents alike, with its potential to reshape Medicare supplement insurance in Oregon hanging in the balance.