3 AAC 28.440. Policy provisions

(a) Except for permitted preexisting condition clauses described in 3 AAC 28.450 and 3 AAC 28.453, a policy or certificate may not be advertised, solicited, or issued for delivery in this state as a medicare supplement policy if that policy or certificate contains limitations or exclusions on coverage that are more restrictive than those of medicare.

(b) A medicare supplement policy or certificate in force in this state may not contain benefits that duplicate benefits provided by medicare.

(c) A medicare supplement policy or certificate may not exclude, limit, or reduce coverage or benefits for specifically named or described preexisting diseases or physical conditions.

(d) Reserved.

(e) A medicare supplement policy or certificate may not contain the terms "Medicare Supplement," or "Medigap," or words of similar import, unless the policy or certificate is issued in compliance with 3 AAC 28.410 - 3 AAC 28.510.

(f) Subject to 3 AAC 28.450(a) (6) and (7), (d), (f), and (i), and 3 AAC 453(b)(4) and (5), an issuer shall renew, at the option of the policyholder, a medicare supplement policy that includes benefits for outpatient prescription drugs and that was issued before January 1, 2006, if the policyholder does not enroll in medicare Part D.

(g) After December 31, 2005, an issuer may not issue a medicare supplement policy that includes benefits for outpatient prescription drugs.

(h) After December 31, 2005, an issuer may not renew a medicare supplement policy that includes benefits for outpatient prescription drugs if the policyholder enrolls in medicare Part D unless the

(1) policy is modified to remove coverage for outpatient prescription drug expenses incurred by the policyholder after the effective date of policyholder's coverage under medicare Part D; and

(2) premium for the modified policy is adjusted to reflect the removal of the outpatient prescription drug coverage.

History: Eff. 3/26/82, Register 81; am 8/8/90, Register 115; am 7/1/92, Register 122; am 9/4/2005, Register 175

Authority: AS 21.06.090

AS 21.42.130

AS 21.89.060

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