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HB2433 • 2026

medicare supplement insurance; ALS; ESRD

HB2433 - medicare supplement insurance; ALS; ESRD

Passed Legislature

This bill passed both chambers and reached final enrollment, even if later executive action is not shown here.

Sponsor
Selina Bliss
Last action
2026-01-21
Official status
House second read
Effective date
Not listed

Plain English Breakdown

The official source material does not provide specific details on how insurers will handle situations where applications are unavailable during the specified enrollment periods.

Medicare Supplement Insurance for ALS and ESRD

This bill requires Medicare supplement insurance companies to offer policies to people under age 65 who have end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS), with the same benefits as those over 65, and sets specific enrollment periods and premium rate rules.

What This Bill Does

  • Requires insurers offering Medicare supplement insurance to individuals aged 65 and older to also offer policies to people under age 65 who have ESRD or ALS.
  • Specifies that all benefits available to Medicare enrollees at age 65 must be available to those under 65 with ESRD or ALS.
  • Allows people under 65 with ESRD or ALS to enroll in a Medicare supplement insurance policy within six months of enrolling in Medicare Part B, receiving retroactive enrollment notice, or losing group health coverage.
  • Provides an additional enrollment period from December 2, 2025, to June 1, 2027, for people under 65 with ESRD or ALS to apply for coverage.
  • Prohibits insurers from charging higher premiums to younger enrollees based on age.

Who It Names or Affects

  • People under the age of 65 who have end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS).
  • Insurance companies that offer Medicare supplement insurance policies in Arizona.
  • The Department of Insurance and Financial Institutions (DIFI)

Terms To Know

End-Stage Renal Disease (ESRD)
A condition where the kidneys have stopped working well enough to meet the needs of daily life.
Amyotrophic Lateral Sclerosis (ALS)
A disease that affects nerve cells in the brain and spinal cord, leading to loss of muscle control.

Limits and Unknowns

  • The bill does not specify what happens if an application is unavailable during the specified enrollment period.
  • It relies on federal laws for some aspects but may require additional rules from DIFI to fully implement.
  • The effective date and any potential executive action are not provided.

Bill History

  1. 2026-01-21 House

    House second read

  2. 2026-01-20 House

    House Rules: None

  3. 2026-01-20 House

    House Health & Human Services: DP

  4. 2026-01-20 House

    House first read

Official Summary Text

HB2433 - 572R - House Bill Summary

ARIZONA HOUSE OF REPRESENTATIVES

57th
Legislature, 2nd Regular Session

Majority Research Staff

House:
HHS DP 12-0-0-0

HB
2433
: medicare supplement insurance; ALS; ESRD

Sponsor:
Representative Bliss, LD 1

Caucus
& COW

Overview

Requires
insurers that offer Medicare supplement insurance policies to individuals age
65 to also offer Medicare supplement insurance policies to eligible enrollees
with end-stage renal disease or amyotrophic lateral sclerosis. Establishes
enrollment periods for individuals under the age of 65 and enrolled in Medicare
Part B due to end-stage renal disease or amyotrophic lateral sclerosis,
allowing applications for coverage within specified timeframes. Prohibits
insurers from charging higher premium rates to younger enrollees based on age.

History

The Department of Insurance and Financial Institutions (DIFI)
is required to adopt necessary rules to comply with any federal laws or
regulations pertaining to retain its full authority to regulate minimum
standards for Medicare supplement insurance.� An insurer may file for Medicare
supplement rates that include an early enrollment discount that will not be
considered an attained age rating structure. An early enrollment discount must diminish
over a period of time and is only available to enrollees who purchase the plan
within the early enrollment period designated by the insurer. Insurers must disclose
to all applicants how the early enrollment discount will diminish over time (
A.R.S. �
20-1133
).

Provisions

1.

Requires an
insurer that offers Medicare supplement insurance policies in Arizona to
persons who are at least 65 years of age to also offer Medicare supplement
insurance policies to persons who are eligible for an enrolled in Medicare due
to end-stage renal disease (ESRB) or amyotrophic lateral sclerosis (ALS). (Sec.
1)

2.

Specifies
that all benefits and coverages that are available to Medicare enrollees at age
65 must also be available to Medicare enrollees under the age of� 65 and who
are enrolled due to ESRD or ALS. (Sec. 1)

3.

Allows a
Medicare enrollee to enroll in a Medicare supplement insurance policy at any
time allowed or required by federal law or within six months after any of the
following:

a.

enrolling in
Medicare Part B or January 1, 2027, for an enrollee who is under 65 years of
age and eligible for Medicare due to ESRB or ALS, whichever is later;

b.

receiving
notice that the enrollee has been retroactively enrolled in Medicare Part B due
to a retroactive eligibility decision made by the Social Security
Administration; and

c.

termination
of coverage under a group health insurance plan. (Sec. 1)

4.

Allows, in
addition to other enrollment periods, a person who is under 65 years of age and
enrolled in Medicare Part B due to ESRD or ALS to apply for coverage under a
Medicare supplement insurance policy on or after December 2, 2025, and before
June 1, 2027. �����(Sec. 1)

5.

Provides a
six-month extension to individuals who are unable to submit an application for
coverage because the application was unavailable between December 2, 2025, and
June 1, 2027, and the applicant requested the application during that time
period.������� �(Sec. 1)

6.

Prohibits an
insurer from charging an enrollee who qualifies for Medicare due to ESRD or ALS
and under 65 years of age a premium rate for a medical supplemental insurance
benefit plan offered by the insurer that exceeds the insurer's rate schedule
that is filed with DIFI for that plan and is charged to enrollees who are 65
years of age. (Sec. 1)

7.

Makes
technical and conforming changes. (Sec. 1)

8.

9.

10.

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FOOTER ---------

11.

Initials AG���������������������� HB
2433

12.

2/13/2026 Page 0 Caucus
& COW

13.

14.

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FOOTER ---------

Current Bill Text

Read the full stored bill text
HB2433 - 572R - I Ver

REFERENCE TITLE:�
medicare supplement insurance; ALS; ESRD

State of Arizona

House of Representatives

Fifty-seventh Legislature

Second Regular Session

2026

HB 2433

Introduced by

Representative
Bliss

AN
ACT

amending section 20-1133, arizona
revised statutes; relating to medicare supplement insurance.

(TEXT OF BILL BEGINS ON NEXT PAGE)

Be it enacted by the Legislature of the State of Arizona:

Section 1. Section 20-1133, Arizona Revised
Statutes, is amended to read:

START_STATUTE
20-1133.

Medicare supplement insurance; early enrollment discounts; eligibility
for additional conditions; applicability

A. The director shall adopt rules necessary to
comply with the requirements of the social security disability amendments of
1980 (P.L. 96-265; 42 United States Code section 1395ss) and any
federal laws or regulations pertaining to that section, so that this state may
retain its full authority to regulate minimum standards for medicare supplement
insurance.

B. For the purposes of this section, an insurer may
file for medicare supplement
insurance
rates that include
an early enrollment discount that will not be considered an attained age rating
structure. An early enrollment discount shall diminish over a period
of time and is only available to enrollees who purchase the plan within the
early enrollment period designated by the insurer. Insurers shall
disclose to all applicants how the early enrollment discount will diminish over
time.

C. Subject to the other limitations provided in this
subsection, a benefit mandated in this title for health insurance policies does
not apply to medicare supplement insurance policies unless the mandated policy
benefit is set forth in rules adopted pursuant to this section or unless the
statute mandating the policy benefit expressly states that it is made
specifically applicable to medicare supplement insurance policies. A
medicare supplement insurance policy may not contain any exclusion for services
provided by any type of properly licensed health care provider if the
provider's services are eligible for medicare reimbursement and if the specific
services in question would be covered by medicare. The scope of
benefits of a medicare supplement policy may not be less than the minimum level
of benefits established by federal law.

D. An insurer that offers medicare
supplement insurance policies in this state to persons who are at least sixty-five
years of age shall also offer medicare supplement insurance policies to persons
who are eligible for and enrolled in medicare due to end-stage renal
disease or amyotrophic lateral sclerosis. All benefits and coverages
that are available to medicare enrollees who are at least sixty-five
years of age must also be available to medicare enrollees who are under sixty-five
years of age and who are enrolled due to end-stage renal disease or
amyotrophic lateral sclerosis.

E. A medicare enrollee may enroll in
a medicare supplement insurance policy at any time allowed or required by
federal law or within six months after any of the following:

1. Enrolling in medicare part B or
January 1, 2027 for an enrollee who is under sixty-five years of age and
who is eligible for medicare due to end-stage renal disease or
amyotrophic lateral sclerosis, whichever is later.

2. Receiving notice that the enrollee
has been retroactively enrolled in medicare part B due to a retroactive
eligibility decision made by the social security administration.

3. Termination of coverage under a
group health insurance plan.

f. In addition to other enrollment
periods provided by law, a person who is under sixty-five years of age
and who is enrolled in medicare part b due to end-stage renal disease or
amyotrophic lateral sclerosis on the effective date of this AMENDMENT to this
section may apply for coverage under a medicare supplement insurance policy on
or after December 2, 2025 and before June 1, 2027.� If the person is unable to
submit an application for coverage on or after December 2, 2025 and before June
1, 2027 because the application was not available and the person requested the
application during that time period, the person may apply for coverage WITHIN
six months after the date the application initially becomes available.

g. An insurer may not charge an
enrollee who qualifies for medicare due to end-stage renal disease or
amyotrophic lateral sclerosis and who is under sixty-five years of age a
premium rate for a medical supplemental insurance benefit plan offered by the
insurer that exceeds the insurer's rate schedule that is filed with the
department for that PLAN and that is charged to enrollees who are sixty-five
years of age.

D.

H.
Notwithstanding
any other provision of this title, rules adopted pursuant to this section apply
to insurance provided under disability insurance policies, under subscription
contracts of hospital, medical, dental or optometric service corporations,
under certificates of fraternal benefit societies, under evidences of coverage
of health care services organizations and under coverages issued by any other
insurer, which policies, contracts, certificates, membership coverages,
evidences of coverage and coverages are delivered or issued for delivery in
this state on or after the effective date of rules adopted pursuant to
subsection A of this section. In adopting the rules required by
subsection A of this section, the director shall prescribe an effective date of
the rules that will allow insurers sufficient time to bring their forms and
practices into compliance with the requirements of the rule.
END_STATUTE