Rule 20:06:13:74 Required offer of replacement coverage without a restricted network provision.
20:06:13:74. Required offer of replacement coverage without a
restricted network provision. At the request of an individual insured under
a Medicare select policy or certificate, a Medicare select issuer must make
available to the individual insured the opportunity to purchase a Medicare
supplement policy or certificate offered by the issuer which has comparable or
lesser benefits and which does not contain a restricted network provision. The
issuer must make such policies or certificates available without requiring
evidence of insurability after the Medicare select policy or certificate has
been in force for six months.
For the purpose of this section, a
Medicare supplement policy or certificate is considered to have comparable or
lesser benefits unless it contains one or more significant benefits not
included in the Medicare select policy or certificate being replaced. For the
purpose of this paragraph, a significant benefit means coverage for the
Medicare Part A deductible, coverage for prescription drugs, coverage for
at-home recovery services, or coverage for Part B excess charges.
22 SDR 107, effective February 18, 1996.
Authority: SDCL 58-17A-2(2), 58-17A-2(11), 58-17A-2(14).
Implemented: SDCL 58-17A-2.
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