§ 26.1-36.1-02 — Standards for Medicare supplement policies

North Dakota § 26.1-36.1-02

• Jurisdiction: North Dakota
• Title 26.1: Insurance
• Ch. 26.1-36.1: Medicare Supplement Policies

Text

1. The commissioner shall adopt reasonable rules to establish specific standards for
provisions of Medicare supplement policies. The standards are in addition to and in
accordance with applicable laws of this state, and may include coverage of:
a. Terms of renewability.
b. Initial and subsequent conditions of eligibility.
c. Nonduplication of coverage.
d. Probationary periods.
e. Benefit limitations, exceptions, and reductions.
f. Elimination periods.
g. Requirements for replacement.
h. Recurrent conditions.
i. Definition of terms.
2. The commissioner may adopt rules that specify prohibited Medicare supplement policy
provisions not otherwise specifically authorized by statute which, in the opinion of the
commissioner, are unjust, unfair, or unfairly discriminatory to any person insured or
proposed for coverage under a Medicare supplement policy or certificate.
3. Notwithstanding any other law, a Medicare supplement policy or certificate may not
deny a claim for losses incurred for more than six months from the effective date of
coverage for a pre-existing condition. The policy or certificate may not define a pre-
existing condition more restrictively than a condition for which medical advice was
given or treatment was recommended by or received from a physician within six
months before the effective date of coverage.
4. No Medicare supplement insurance policy, contract, or certificate in force in the state
may contain benefits that duplicate benefits provided by Medicare.