§ 26-38-203 — Standards for policy provisions

Wyoming § 26-38-203

• Jurisdiction: Wyoming
• Title 26: Insurance Code
• Ch. 38: LONG-TERM CARE INSURANCE

Text

(a) No Medicare supplement insurance policy or certificate
in force in the state shall contain benefits which duplicate
benefits provided by Medicare.
(b) The commissioner shall adopt reasonable regulations to
establish specific standards for policy provisions of Medicare
supplement policies and certificates. The standards shall be in
addition to and in accordance with applicable laws of this
state. No requirement of the code relating to minimum required
policy benefits, other than the minimum standards contained in
this act, shall apply to Medicare supplement policies and
certificates. The standards may cover, but are not limited to:
(i) Terms of renewability;
(ii) Initial and subsequent conditions of
eligibility;
(iii) Nonduplication of coverage;
(iv) Probationary periods;
(v) Benefit limitations, exceptions and reductions;
(vi) Elimination periods;
(vii) Requirements for replacement;
(viii) Recurrent conditions; and
(ix) Definitions of terms.
(c) The commissioner shall adopt reasonable regulations
that specify prohibited 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.
(d) Notwithstanding any other provision of law or
contract, a Medicare supplement policy or certificate shall not
exclude or limit benefits for losses incurred more than ninety
(90) days from the effective date of coverage because the loss
involved a preexisting condition. The policy or certificate
shall not define a preexisting condition more restrictively than
a condition for which medical advice was given or treatment was
recommended by or received from a physician within ninety (90)
days before the effective date of coverage.