19 Miss. Code. R. 3-10.06 - Policy Provisions
A. Except for
permitted preexisting condition clauses as described in Rules
10.07 A(1), 10.08A(1), and
10.08.1A(1) of this regulation, no policy or certificate may be advertised,
solicited or issued for delivery in this state as a Medicare supplement policy
if the policy or certificate contains limitations or exclusions on coverage
that are more restrictive than those of Medicare.
B. No Medicare supplement policy or
certificate may use waivers to exclude, limit or reduce coverage or benefits
for specifically named or described preexisting diseases or physical
conditions.
C. No Medicare
supplement policy or certificate in force in the state shall contain benefits
that duplicate benefits provided by Medicare.
D.
1.
Subject to Rules
10.07 A(4), (5) and (7), and
10.08A(4) and (5) of this regulation, a Medicare supplement policy with
benefits for outpatient prescription drugs in existence prior to January 1,
2006 shall be renewed for current policyholders who do not enroll in Part D at
the option of the policyholder.
2.
A Medicare supplement policy with benefits for outpatient prescription drugs
shall not be issued after December 31, 2005.
3. After December 31, 2005, a Medicare
supplement policy with benefits for outpatient prescription drugs may not be
renewed after the policyholder enrolls in Medicare Part D unless:
a. The policy is modified to eliminate
outpatient prescription coverage for expenses of outpatient prescription drugs
incurred after the effective date of the individual's coverage under a Part D
plan and;
b. Premiums are adjusted
to reflect the elimination of outpatient prescription drug coverage at the time
of Medicare Part D enrollment, accounting for any claims paid, if applicable.
Notes
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