NAC687B.306. Standardized Benefit Plan D.

A 1990 standardized benefit plan to supplement Medicare which is designated as Standardized Benefit Plan D must provide the following benefits:

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

     2. Coverage for all of the Medicare Part A inpatient hospital deductible amount per benefit period.

     3. For Medicare Part A eligible expenses for posthospital care received at a skilled nursing facility, coverage for the actual billed charges up to the coinsurance amount from the 21st day through the 100th day in any Medicare benefit period.

     4. Coverage of Medicare eligible expenses for 80 percent of the billed charges for medically necessary emergency care received in a foreign country to the extent not covered by Medicare, if such care would have been covered by Medicare if provided in the United States and the care began during the first 60 consecutive days of the trip outside the United States. The benefit is subject to the payment of a deductible of $250 per calendar year and a lifetime maximum benefit of $50,000. As used in this subsection, “emergency care” means medical care needed immediately because of a sudden and unexpected injury or illness.

     5. Coverage for short-term services that provide to a person recovering from an illness, injury or surgery in his or her home, assistance with daily activities such as bathing, dressing, personal hygiene, eating, ambulating, administering prescription drugs and changing bandages and other dressings. The coverage must comply with the requirements of NAC 687B.325.

     (Added to NAC by Comm’r of Insurance, 7-16-92, eff. 7-30-92; A by R049-09, 10-27-2009)