NAC687B.725. Notice of duplication for policy which provides reimbursement for expenses incurred for specified limited services.

     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 limited services 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 expenses relating to the specific services 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:

· any of the services covered by the policy are also covered by Medicare

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

· hospitalization

· physician services

· 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)