NAC687B.720. Notice of duplication for policy which provides reimbursement for expenses incurred for specified diseases and 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 for expenses incurred for specified diseases and 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 provides limited benefits, if you meet the policy conditions, for hospital or medical expenses only when you are treated for one of the specific diseases or health conditions listed 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 when it pays:

    · hospital or medical expenses up to the maximum stated in the policy

    Medicare generally pays for most or all of these expenses.

    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 Comm’r of Insurance, eff. 5-13-96; A 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)