6.6.613    PROVISION FOR CONTINUED COVERAGE

(1) Medicare select policies and certificates shall provide for continuation of coverage in the event the United States department of health and human services determines that medicare select policies and certificates issued pursuant to ARM 6.6.601 through 6.6.614 should be discontinued due to either the failure of the medicare select program to be reauthorized under law or its substantial amendment.

(2) Each medicare select issuer shall make available to each individual insured under a medicare select policy or certificate the opportunity to purchase any 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 shall make such policies and certificates available without requiring evidence or insurability.

(3) For the purpose of this rule, a medicare supplement policy or certificate will be 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 (3) , a significant benefit means coverage for the medicare part A deductible, coverage for at-home recovery services, or coverage for part B excess charges.

(4) In the event of the discontinuance of the medicare select insurance program by an entity, (including but not limited to the federal government, an insurer, an insurance company, health maintenance organization or health service corporation) the insured will have the option to continue medicare supplement insurance. The insured may select from any of the medicare supplement insurance plans then currently available with no restrictions or limitations.

History: 33-22-904 and 33-22-905, MCA; IMP, 33-15-303, 33-22-901, 33-22-902, 33-22-903, 33-22-904, 33-22-905, 33-22-906, 33-22-907, 33-22-908, 33-22-909, 33-22-910, 33-22-911, 33-22-921, 33-22-922, 33-22-923, and 33-22-924, MCA; NEW, 1996 MAR p. 1645, Eff. 4/5/96; AMD, 2005 MAR p. 1672, Eff. 9/9/05.