Current through 2024 Legislative Session
Section 26.1-36.1-02 - Standards for Medicare supplement policies1. The commissioner shall adopt reasonable rules to establish specific standards for provisions of Medicare supplement policies. The standards are in addition to and in accordance with applicable laws of this state, and may include coverage of: a. Terms of renewability.b. Initial and subsequent conditions of eligibility.c. Nonduplication of coverage.e. Benefit limitations, exceptions, and reductions.g. Requirements for replacement.2. The commissioner may adopt rules that specify prohibited Medicare supplement policy provisions not otherwise specifically authorized by statute which, in the opinion of the commissioner, are unjust, unfair, or unfairly discriminatory to any person insured or proposed for coverage under a Medicare supplement policy or certificate.3. Notwithstanding any other law, a Medicare supplement policy or certificate may not deny a claim for losses incurred for more than six months from the effective date of coverage for a pre-existing condition. The policy or certificate may not define a pre-existing condition more restrictively than a condition for which medical advice was given or treatment was recommended by or received from a physician within six months before the effective date of coverage.4. No Medicare supplement insurance policy, contract, or certificate in force in the state may contain benefits that duplicate benefits provided by Medicare.