NAC687B.711. Notice of duplication for policy which provides reimbursement in fixed dollar amounts for specified diseases or other specified impairments.  


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  •      1. An insurer that delivers or issues for delivery in this State a policy of health insurance which provides reimbursement in fixed dollar amounts for specified diseases or other specified impairments and which provides benefits that are provided under Medicare shall provide notice to the insured that the policy contains certain benefits which are also provided under Medicare.

         2. The notice must be:

         (a) Printed on or attached to the first page of the application for the policy; and

         (b) In not less than 12-point type and must not vary from the following form in terms of language or format:

    Important Notice to Persons on Medicare

    This Insurance Duplicates Some Medicare Benefits

    This is not Medicare Supplement Insurance

    This insurance pays a fixed amount, regardless of your expenses, if you meet the policy conditions, for one of the specific diseases or health conditions named in the policy. It does not pay your Medicare deductibles or coinsurance and is not a substitute for Medicare Supplement insurance.

    This insurance duplicates Medicare benefits because Medicare generally pays for most of the expenses for the diagnosis and treatment of the specific conditions or diagnoses named in the policy.

    Medicare pays extensive benefits for medically necessary services regardless of the reason you need them. These include:

    · hospitalization

    · physician services

    · hospice

    · outpatient prescription drugs if you are enrolled in Medicare Part D

    · other approved items and services

    Before You Buy This Insurance

    ü Check the coverage in all health insurance policies you already have.

    ü For more information about Medicare and Medicare Supplement insurance, review the Guide to Health Insurance for People with Medicare, available from the insurance company.

    ü For help in understanding your health insurance, contact the Commissioner of Insurance or the State Health Insurance Assistance Program (SHIP).

     (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)