RULES AND REGULATIONS

Title 31--INSURANCE

INSURANCE DEPARTMENT

[31 PA. CODE CH. 89]

[31 Pa.B. 145]

[Correction]

Medicare Supplement Insurance

   An error appeared in a chart at 30 Pa.B. 6886, 6890 (December 30, 2000). The correct version of this chart appears in Annex A, with ellipses referring to the existing text of the regulation.

Annex A

TITLE 31.  INSURANCE

PART IV.  LIFE INSURANCE

CHAPTER 89.  APPROVAL OF LIFE, ACCIDENT AND HEALTH INSURANCE

Subchapter K.  MEDICARE SUPPLMENT INSURANCE MINIMUM STANDARDS

§ 89.783.  Required disclosure provisions.

*      *      *      *      *

    

[COMPANY NAME]

Outline of Medicare Supplement Coverage-Cover Page:

   

Benefit Plans ______ (insert letters of plans being offered)

Medicare supplement insurance can be sold in only ten standard plans plus two high deductible plans. This chart shows the benefits included in each plan. Every company must make available Plan A & B.

Basic Benefits:  Included in All Plans.
Hospitalization: Part A coinsurance plus coverage for 365 additional days after Medicare benefits end.
Medical Expenses:  Part B coinsurance (20% of Medicare-approved expenses) or, in the case of hospital outpatient department
services under a prospective payment system, applicable copayments.
Blood:  First three pints of blood each year.
 

A	B	C	D	E	F	F*	G	H	I	J	J*
Basic Benefits	Basic Benefits	Basic Benefits	Basic Benefits	Basic Benefits	Basic Benefits		Basic Benefits	Basic Benefits	Basic Benefits	Basic Benefits
		Skilled Nursing Co-Insurance	Skilled Nursing Co-Insurance	Skilled Nursing Co-Insurance	Skilled Nursing Co- Insurance		Skilled Nursing Co-Insurance	Skilled Nursing Co-Insurance	Skilled Nursing Co-Insurance	Skilled Nursing Co- Insurance
	Part A Deductible	Part A Deductible	Part A Deductible	Part A Deductible	Part A Deductible		Part A Deductible	Part A Deductible	Part A Deductible	Part A Deductible
		Part B Deductible			Part B Deductible					Part B Deductible
					Part B Excess (100%)		Part B Excess (80%)	Part B Excess (100%)	Part B Excess (100%)
		Foreign Travel Emergency	Foreign Travel Emergency	Foreign Travel Emergency	Foreign Travel Emergency		Foreign Travel Emergency	Foreign Travel Emergency	Foreign Travel Emergency	Foreign Travel Emergency
			At-Home Recovery				At-Home Recovery	At-Home Recovery	At-Home Recovery
								Basic Drugs ($1,250 Limit)	Basic Drugs ($1,250 Limit)	Extended Drugs ($3,000 Limit)
				Preventive Care						Preventive Care

* Plans F and J also have an option called a high deductible plan F and a high deductible plan J. These high deductible plans pay the same or offer the same benefits as Plans F and J after one has paid a calendar year $1,580 deductible. Benefits from high deductible plans F and J will not begin until out-of-pocket expenses are $1580. Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by the policy. These expenses include the Medicare deductibles for Part A and Part B, but does not include, in plan J, the plan's separate prescription drug deductible or, in Plans F and J, the plan's separate foreign travel emergency deductible.

[Pa.B. Doc. No. 01-2260. Filed for public inspection December 29, 2001, 9:00 a.m.]

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