Utah Admin. Code R590-146-6 - Policy Provisions
(1) Except for a
permitted preexisting condition clause, a policy or certificate may not be
advertised, solicited, or issued for delivery as a Medicare supplement
insurance policy if the policy or certificate contains a preexisting limitation
or exclusion that is more restrictive than those of Medicare.
(2) A policy or certificate may not use
waivers to exclude, limit, or reduce coverage or benefits for specifically
named or described preexisting diseases or physical conditions.
(3) A policy or certificate may not contain
benefits that duplicate benefits provided by Medicare.
(4)
(a)
Subject to Subsections R590-146-7(1)(d), R590-146-7(1)(e), R590-146-7(1)(g),
R590-146-8(1)(d), and R590-146-8(1)(e), a policy with benefits for outpatient
prescription drugs in existence before January 1, 2006, shall be renewed for
current policyholders who do not enroll in Medicare Part D at the option of the
policyholder.
(b) A policy with
benefits for outpatient prescription drugs may not be issued after December 31,
2005.
(c) After December 31, 2005,
a policy with benefits for outpatient prescription drugs may not be renewed
after the policyholder enrolls in Medicare Part D unless:
(i) 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 Medicare
Part D plan; and
(ii) premiums are
adjusted to reflect the elimination of outpatient prescription coverage as of
Medicare Part D enrollment, accounting for any claims paid.
Notes
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