S.D. Admin. R. 20:06:13:17.16

Current through Register Vol. 51, page 67, December 16, 2024

Section 20:06:13:17.16 - Standard Medicare supplement benefit plans for 2020 standardized Medicare supplement benefit plan policies or certificates issued for delivery to individuals newly eligible for Medicare after December 31, 2019

No policy or certificate that provides coverage for the Medicare Part B deductible may be advertised, solicited, delivered or issued for delivery in this state as a Medicare supplement policy or certificate to individuals newly eligible for Medicare after December 31, 2019. All policies must comply with the following benefit standards.

The standards and requirements of 20:06:13:17.14 and 20:06:13:17.15 shall apply to all Medicare supplement policies or certificates delivered or issued for delivery to individuals newly eligible for Medicare after December 31, 2019, with the following exceptions:

(1) Standardized Medicare supplement benefit Plan C is redesignated as Plan D and shall provide the benefits contained in 20:06:13:17:15(3) but shall not provide coverage for one hundred percent (100%) or any portion of the Medicare Part B deductible;

(2) Standardized Medicare supplement benefit Plan F is redesignated as Plan G and shall provide the benefits contained 20:06:13:17:15 (5) but shall not provide coverage for one hundred percent (100%) or any portion of the Medicare Part B deductible;

(3) Standardized Medicare supplement benefit plans C, F, and F with High Deductible may not be offered to individuals newly eligible for Medicare after December 31, 2019; and

(4) Standardized Medicare supplement benefit Plan F With High Deductible is redesignated as Plan G With High Deductible and shall provide the benefits contained in 20:06:13:17:15(6) but shall not provide coverage for one hundred percent (100%) or any portion of the Medicare Part B deductible, provided further that, the Medicare Part B deductible paid by the beneficiary shall be considered an out-of-pocket expense in meeting the annual high deductible.

The reference to Plans C or F contained in 20:06:13:17.14 is deemed a reference to Plans D or G for purposes of this section.

This section applies to only individuals that are newly eligible for Medicare after December 31, 2019, by reason of:

(1) Attaining age 65 after December 31, 2019; or

(2) By reason of entitlement to benefits under part A pursuant to section 226(b) or 226A of the Social Security Act, or who is deemed to be eligible for benefits under section 226(a) of the Social Security Act on or after January 1, 2020.

For purposes of 20:06:13:81, in the case of any individual newly eligible for Medicare after December 31, 2019, any reference to a Medicare supplement policy C or F, including F With High Deductible, shall be deemed to be a reference to Medicare supplement policy D or G, including G With High Deductible.

After December 31, 2019, the standardized benefit plans described above may be offered to any individual who was eligible for Medicare on or prior to January 1, 2020 in addition to the standardized plans described in 20:06:13:17.15.

S.D. Admin. R. 20:06:13:17.16

44 SDR 184, effective 6/25/2018; 46 SDR 146, effective 7/2/2020

General Authority: SDCL 58-17A-2.

Law Implemented: SDCL 58-17A-2.