NAC687B.207. Coverage if application is submitted before or during first 6-month period in which person is both 65 years of age or older and enrolled under Medicare Part B; availability of coverage to all qualified applicants.

     1. If an application for a policy to supplement Medicare or a certificate is submitted to an issuer before or during the first 6-month period during which a person is both 65 years of age or older and is enrolled for benefits under Medicare Part B, the issuer may not deny or condition the issuance or effectiveness of the policy or certificate or discriminate in the pricing of the policy or certificate on the basis of:

     (a) The health status of the applicant;

     (b) The claims experience of the applicant;

     (c) The receipt of health care by the applicant; or

     (d) The medical condition of the applicant.

     2. A policy to supplement Medicare or a certificate which is available from an issuer must be made available to all qualified applicants, regardless of age.

     3. Except as otherwise provided in subsection 4, the provisions of subsection 1 do not prevent the exclusion of benefits under a policy to supplement Medicare or a certificate, for the first 6 months, based on a preexisting condition for which the policyholder or certificate holder received treatment or was otherwise diagnosed during the 6 months before the policy or certificate became effective.

     4. If an applicant submits an application to an issuer in the manner set forth in subsection 1 and, as of the date on which he or she submits the application, the applicant has not had a break of more than 63 consecutive days in his or her creditable coverage and has had an aggregate period of creditable coverage for:

     (a) Six months or more, the issuer shall not exclude any benefits based on a preexisting condition of the applicant; or

     (b) Less than 6 months, the issuer shall use the method of reduction set forth in 45 C.F.R. § 146.111(a)(1)(iii) to reduce the period of exclusion for a preexisting condition.

     5. As used in this section, “creditable coverage” has the meaning ascribed to it in NRS 689A.505.

     (Added to NAC by Comm’r of Insurance, 7-16-92, eff. 7-30-92; A 8-2-94; 5-13-96; R110-98, 2-23-99)