Idaho Administrative Code › Title IDAPA 18 - Insurance, Department of › Rule 18.04.10 - MEDICARE SUPPLEMENT INSURANCE STANDARDS › Section 18.04.10.071 - REQUIREMENTS FOR APPLICATION FORMS AND REPLACEMENT COVERAGE

Current through August 31, 2023
01.
Application Forms
.
			 Application forms include the following questions designed to elicit
			 information as to whether, as of the date of the application, the applicant
			 currently has another Medicare supplement, Medicare Advantage, Medicaid
			 coverage, or another health insurance policy or certificate in force or whether
			 a Medicare supplement policy or certificate is intended to replace any other
			 accident and sickness policy or certificate presently in force. A supplementary
			 application or other form to be signed by the applicant and agent containing
			 such questions and statements may be used. (3-31-22)
02.
Statements
. (3-31-22)
a. You do not need more than one (1) Medicare
			 supplement policy. (3-31-22)
b. If
			 you purchase this policy, you may want to evaluate your existing health
			 coverage and decide if you need multiple coverages. (3-31-22)
c. You may be eligible for benefits under
			 Medicaid and not need a Medicare supplement policy. (3-31-22)
d. If, after purchasing this policy, you
			 become eligible for Medicaid, the benefits and premiums under your Medicare
			 supplement policy can be suspended, if requested, during your entitlement to
			 benefits under Medicaid for twenty-four (24) months. You need to request this
			 suspension within ninety (90) days of becoming eligible for Medicaid. If you
			 are no longer entitled to Medicaid, your suspended Medicare supplement policy
			 (or, if that is no longer available, a substantially equivalent policy) will be
			 reinstituted if requested within ninety (90) days of losing Medicaid
			 eligibility. If the Medicare supplement policy provided coverage for outpatient
			 prescription drugs and you enrolled in Medicare Part D while your policy was
			 suspended, the reinstituted policy will not have outpatient prescription drug
			 coverage, but will otherwise be substantially equivalent to your coverage
			 before the date of the suspension. (3-31-22)
e. If you are eligible for and have enrolled
			 in a Medicare supplement policy by reason of disability and you later become
			 covered by an employer or union-based group health plan, the benefits and
			 premiums under your Medicare supplement policy can be suspended, if requested,
			 while you are covered under the employer or union-based group health plan. If
			 you suspend your Medicare supplement policy under these circumstances, and
			 later lose your employer or union-based group health plan, your suspended
			 Medicare supplement policy (or, if that is no longer available, a substantially
			 equivalent policy) will be reinstituted if requested within ninety (90) days of
			 losing your employer or union-based health plan. If the Medicare supplement
			 policy provided coverage for outpatient prescription drugs and you enrolled in
			 Medicare Part D while your policy was suspended, the reinstituted policy will
			 not have outpatient prescription drug coverage, but will otherwise be
			 substantially equivalent to your coverage before the date of the suspension.
			 (3-31-22)
f. Counseling services
			 are available through the Senior Health Insurance Benefit Advisors program
			 (SHIBA), to provide advice concerning your purchase of Medicare supplement
			 insurance and concerning medical assistance through the state Medicaid program,
			 including benefits as a Qualified Medicare Beneficiary (QMB) and a Specified
			 Low-Income Medicare Beneficiary (SLMB). (3-31-22)