A major update in Texas may open new opportunities for Medicare beneficiaries and for the brokers who support them. As of September 1, 2025, House Bill 2516 officially expands access to Medicare Supplement (Medigap) plans for individuals under age 65 who have been medically diagnosed with End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS).
This change not only broadens eligibility going forward, but also includes a special one-time Open Enrollment (OE) period for individuals who were eligible prior to the effective date but previously unable to enroll.
Below is a breakdown to help you prepare.
Special One-Time Open Enrollment Period
This temporary OE window gives previously eligible ESRD/ALS beneficiaries a second chance to obtain coverage.
Who qualifies?
- Individuals diagnosed with ESRD or ALS before September 1, 2025
Enrollment window:
- December 1, 2025 – June 1, 2026
Plan availability:
- Applicants may choose from all Medicare Supplement plans available in Texas.
Compensation:
- Guaranteed Issue (GI) compensation will be paid during this OE period.
Proof of Diagnosis Required
For applicants under age 65 enrolling due to ESRD or ALS, documentation must be submitted with the application. Acceptable forms include:
- Medicare benefit award letter listing ESRD or ALS
- A signed letter or statement from an M.D. or D.O. confirming diagnosis
Encourage clients to have this documentation ready to avoid delays in processing.
Updated Underwriting Guidelines Available
Mutual of Omaha has updated its underwriting materials to reflect these changes. Brokers can now access the revised guidelines through:
- Market on Demand
- SPA
- Forms and Materials
What This Means for Brokers
This policy change creates a meaningful opportunity to help previously underserved beneficiaries secure critical supplemental coverage. With a long enrollment window and GI compensation available, this update is a win for both clients and agents.
As always, our team at Trusted American Insurance Agency is here to help you navigate the changes and support your business through every update.