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 Nevada Administrative Code (Last Updated: January 6, 2015)
 Chapter687B Contracts of Insurance
  POLICIES SUPPLEMENTARY TO MEDICARE
  Standardized Benefit Plans

  NAC687B.321. Standardized Benefit Plan L.  

Latest version.
  • A 1990 standardized benefit plan to supplement Medicare which is designated as Standardized Benefit Plan L must provide the following benefits:

         1. The benefits required by NAC 687B.290.

         2. Coverage for 75 percent of the Medicare Part A inpatient hospital deductible amount per benefit period until the out-of-pocket limitation is met as described in subsection 8.

         3. Coverage for 75 percent of the coinsurance amount for each day used from the 21st day through the 100th day in a Medicare benefit period for posthospital skilled nursing facility care eligible under Medicare Part A until the out-of-pocket limitation is met as described in subsection 8.

         4. Coverage for 75 percent of cost sharing for all Medicare Part A eligible expenses and respite care until the out-of-pocket limitation is met as described in subsection 8.

         5. Coverage for 75 percent, under Medicare Part A or B, of the reasonable cost of the first 3 pints of blood, or equivalent quantities of packed red blood cells, as defined under federal regulations, unless replaced in accordance with federal regulations, until the out-of-pocket limitation is met as described in subsection 8.

         6. Except for coverage provided in subsection 8, coverage for 75 percent of the cost sharing otherwise applicable under Medicare Part B after the policyholder pays the Part B deductible until the out-of-pocket limitation is met as described in subsection 8.

         7. Coverage of 100 percent of the cost sharing for Medicare Part B preventive services after the policyholder pays the Part B deductible.

         8. Coverage of 100 percent of all cost sharing under Medicare Parts A and B for the balance of the calendar year after the person has reached the out-of-pocket limitation on annual expenditures under Medicare Parts A and B of $2,000 in 2006, indexed each year by the appropriate inflation adjustment specified by the Secretary of Health and Human Services.

     (Added to NAC by Div. of Insurance by R078-05, 11-17-2005, eff. 9-8-2005 for Plans K and L, and 1-1-2006 for Medicare Part D Prescription Drug Benefit; A by Comm’r of Insurance by R049-09, 10-27-2009)