Alaska Administrative Code › Title 3 - Commerce, Community, and Economic Development › Part 2 - Division of Insurance › Chapter 28 - Life, Health, Variable, and Related Insurance › Article 5 - Health Insurance Marketed as Medicare Supplements › 3 AAC 28.502 - Notice regarding policies or certificates that are not medicare supplement policies

Current through May 31, 2024
(a) A health insurance policy or certificate,
				  other than a medicare supplement policy; a policy issued under a contract under
				  42 U.S.C.
				  1395-
				  1395 ccc (sec. 1876 of the Social
				  Security Act); or a disability income policy or certificate delivered or issued
				  for delivery in this state to a person eligible for medicare must notify
				  insureds under the policy or certificate that the policy or certificate is not
				  a medicare supplement policy. The notice must either be printed on or attached
				  to the first page of the outline of coverage delivered to the insured under the
				  policy or certificate, or, if no outline of coverage is delivered, to the first
				  page of the policy or certificate delivered to the insured. The notice must be
				  in no less than 12-point type and must contain the following language:
"THIS (POLICY OR CERTIFICATE) IS NOT A MEDICARE SUPPLEMENT
					 POLICY. If you are eligible for medicare, review the guide to health insurance
					 for people with medicare available from the company."
(b) An application for a health insurance
				  policy or certificate described in (a) of this section that is provided to a
				  person eligible for medicare must disclose, using the applicable disclosure
				  statement contained in Appendix A of this section, the extent to which the
				  policy duplicates medicare benefits. The disclosure statement must be provided
				  as a part of, or together with, the application for the policy or
				  certificate.
Appendix A DISCLOSURE STATEMENTS
Instructions for use of the Disclosure Statements for
					 Health Insurance Policies Sold to Medicare Beneficiaries that Duplicate
					 Medicare
1.
										42 U.S.C.
				  1395ss(d) (sec. 1882(d) of
				  the Social Security Act) prohibits the sale of a health insurance policy (the
				  term "policy" or "policies" includes "certificates") that duplicates medicare
				  benefits unless the policy will pay benefits without regard to other health
				  coverage and includes the prescribed disclosure statement on or together with
				  the application.
2. All types of
				  health insurance policies that duplicate medicare must include one of the
				  attached disclosure statements, according to the particular policy type
				  involved, on the application or together with the application. The disclosure
				  statement may not vary from the attached statements in terms of language or
				  format (type size, type proportional spacing, bold character, line spacing, and
				  usage of boxes around text).
3.
				  State and federal law prohibits insurers from selling a medicare supplement
				  policy to a person that already has a medicare supplement policy except as a
				  replacement policy.
4.
				  Property/casualty and life insurance policies are not considered health
				  insurance.
5. Disability income
				  policies are not considered to provide benefits that duplicate
				  medicare.
6. Long-term care
				  insurance policies that coordinate with medicare and other health insurance are
				  not considered to provide benefits that duplicate medicare.
7. Federal law does not preempt state laws
				  that are more stringent than the federal requirements.
8. Federal law does not preempt existing
				  state form filing requirements.
9.
										42 U.S.C.
				  1395ss (sec. 1882 of the Social Security Act)
				  was amended in subsection (d)(3)(A) to allow for alternative disclosure
				  statements. The disclosure statements already in this appendix remain. A
				  carrier may use either disclosure statement with the requisite insurance
				  product. A carrier shall use either the original disclosure statements or the
				  alternative disclosure statements, but may not use both
				  simultaneously.
[Original disclosure statement for policies that provide
					 benefits for expenses incurred for an accidental injury only.]
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 that result from accidental
					 injury. 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
- outpatient prescription drugs if you are enrolled in
					 medicare Part D - other approved items and services
Before You Buy This Insurance
UNHANDLEDCHAR Check the coverage in all health insurance
					 policies you already have.
UNHANDLEDCHAR For more information about medicare and
					 medicare supplement insurance, review the Guide to Health Insurance for People
					 with Medicare, available from the insurance company.
UNHANDLEDCHAR For help in understanding your health
					 insurance, contact your state insurance department or state health insurance
					 assistance program (SHIP).
[Original disclosure statement for policies that provide
					 benefits for specified limited services.]
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
UNHANDLEDCHAR Check the coverage in all health insurance
					 policies you already have.
UNHANDLEDCHAR For more information about medicare and
					 medicare supplement insurance, review the Guide to Health Insurance for People
					 with Medicare, available from the insurance company.
UNHANDLEDCHAR For help in understanding your health
					 insurance, contact your state insurance department or state health insurance
					 assistance program (SHIP).
[Original disclosure statement for policies that reimburse
					 expenses incurred for specified diseases or other specified impairments. This
					 includes expense-incurred cancer, specified disease, and other types of health
					 insurance policies that limit reimbursement to named medical conditions.]
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
UNHANDLEDCHAR Check the coverage in all health insurance
					 policies you already have.
UNHANDLEDCHAR For more information about medicare and
					 medicare supplement insurance, review the Guide to Health Insurance for People
					 with Medicare, available from the insurance company.
UNHANDLEDCHAR For help in understanding your health
					 insurance, contact your state insurance department or state health insurance
					 assistance program (SHIP).
[Original disclosure statement for policies that pay fixed
					 dollar amounts for specified diseases or other specified impairments. This
					 includes cancer, specified disease, and other health insurance policies that
					 pay a scheduled benefit or specific payment based on diagnosis of the
					 conditions named in the policy.]
Important Notice To Persons on Medicare
This Insurance Duplicates Some Medicare Benefits
This is not Medicare Supplement Insurance
This insurance pays a fixed amount, regardless of your
					 expenses, if you meet the policy conditions, for one of the specific diseases
					 or health conditions named 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 because
					 medicare generally pays for most of the expenses for the diagnosis and
					 treatment of the specific conditions or diagnoses named in the policy.
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
UNHANDLEDCHAR Check the coverage in all health insurance
					 policies you already have.
UNHANDLEDCHAR For more information about medicare and
					 medicare supplement insurance, review the Guide to Health Insurance for People
					 with Medicare, available from the insurance company.
UNHANDLEDCHAR For help in understanding your health
					 insurance, contact your state insurance department or state health insurance
					 assistance program (SHIP).
[Original disclosure statement for indemnity policies and
					 other policies that pay a fixed dollar amount per day, excluding long-term care
					 policies.]
Important Notice To Persons on Medicare
This Insurance Duplicates Some Medicare Benefits
This is not Medicare Supplement Insurance
This insurance pays a fixed dollar amount, regardless of
					 your expenses, for each day you meet the policy conditions. 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 expenses or services covered by the policy are also
					 covered by medicare
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
UNHANDLEDCHAR Check the coverage in all health insurance
					 policies you already have.
UNHANDLEDCHAR For more information about medicare and
					 medicare supplement insurance, review the Guide to Health Insurance for People
					 with Medicare, available from the insurance company.
UNHANDLEDCHAR For help in understanding your health
					 insurance, contact your state insurance department or state health insurance
					 assistance program (SHIP).
[Original disclosure statement for policies that provide
					 benefits upon both an expense-incurred and fixed indemnity basis.]
Important Notice To Persons on Medicare
This Insurance Duplicates Some Medicare Benefits
This is not Medicare Supplement Insurance
This insurance pays limited reimbursement for expenses if
					 you meet the conditions listed in the policy. It also pays a fixed amount,
					 regardless of your expenses, if you meet other policy conditions. 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 expenses or services covered by the policy are also
					 covered by medicare; or - it pays the fixed dollar amount stated in the policy
					 and medicare covers the same event
Medicare generally pays for most or all of the expenses.
					 Medicare pays extensive benefits for medically necessary services regardless of
					 the reason you need them. These include:
- hospitalization
- physician services
- hospice care
- outpatient prescription drugs if you are enrolled in
					 medicare Part D
- other approved items & services
Before You Buy This Insurance
UNHANDLEDCHAR Check the coverage in all health insurance
					 policies you already have.
UNHANDLEDCHAR For more information about medicare and
					 medicare supplement insurance, review the Guide to Health Insurance for People
					 with Medicare, available from the insurance company.
UNHANDLEDCHAR For help in understanding your health
					 insurance, contact your state insurance department or state health insurance
					 assistance program (SHIP).
[Original disclosure statement for other health insurance
					 policies not specifically identified in the preceding statements.]
Important Notice To Persons on Medicare
This Insurance Duplicates Some Medicare Benefits
This is not Medicare Supplement Insurance
This insurance duplicates medicare benefits when it
					 pays:
- the benefits stated in the policy and coverage for the
					 same event is provided by medicare
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
UNHANDLEDCHAR Check the coverage in all health insurance
					 policies you already have.
UNHANDLEDCHAR For more information about medicare and
					 medicare supplement insurance, review the Guide to Health Insurance for People
					 with Medicare, available from the insurance company.
UNHANDLEDCHAR For help in understanding your health
					 insurance, contact your state insurance department or state health insurance
					 assistance program (SHIP).
[Alternative disclosure statement for policies that
					 provide benefits for expenses incurred for an accidental injury only.]
Important Notice To Persons on Medicare
This is Not Medicare Supplement Insurance
Some health care services paid for by medicare may also
					 trigger the payment of benefits from this policy.
This insurance provides limited benefits, if you meet the
					 policy conditions, for hospital or medical expenses that result from accidental
					 injury. It does not pay your medicare deductibles or coinsurance and is not a
					 substitute for medicare supplement insurance.
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
- outpatient prescription drugs if you are enrolled in
					 medicare Part D
- other approved items and services
This policy must pay benefits without regard to other
					 health benefit coverage to which you may be entitled under medicare or other
					 insurance.
Before You Buy This Insurance
UNHANDLEDCHAR Check the coverage in all health insurance
					 policies you already have.
UNHANDLEDCHAR For more information about medicare and
					 medicare supplement insurance, review the Guide to Health Insurance for People
					 with Medicare, available from the insurance company.
UNHANDLEDCHAR For help in understanding your health
					 insurance, contact your state insurance department or state health insurance
					 assistance program (SHIP).
[Alternative disclosure statement for policies that
					 provide benefits for specified limited services.]
Important Notice To Persons on Medicare
This is Not Medicare Supplement Insurance
Some health care services paid for by medicare may also
					 trigger the payment of benefits under this policy.
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.
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
This policy must pay benefits without regard to other
					 health benefit coverage to which you may be entitled under medicare or other
					 insurance.
Before You Buy This Insurance
UNHANDLEDCHAR Check the coverage in all health insurance
					 policies you already have.
UNHANDLEDCHAR For more information about medicare and
					 medicare supplement insurance, review the Guide to Health Insurance for People
					 with Medicare, available from the insurance company.
UNHANDLEDCHAR For help in understanding your health
					 insurance, contact your state insurance department or state health insurance
					 assistance program (SHIP).
[Alternative disclosure statement for policies that
					 reimburse expenses incurred for specified diseases or other specified
					 impairments. This includes expense-incurred cancer, specified disease, and
					 other types of health insurance policies that limit reimbursement to named
					 medical conditions.]
Important Notice To Persons on Medicare
This is Not Medicare Supplement Insurance
Some health care services paid for by medicare may also
					 trigger the payment of benefits from this policy. Medicare generally pays for
					 most or all of these expenses.
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.
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
This policy must pay benefits without regard to other
					 health benefit coverage to which you may be entitled under medicare or other
					 insurance.
Before You Buy This Insurance
UNHANDLEDCHAR Check the coverage in all health insurance
					 policies you already have.
UNHANDLEDCHAR For more information about medicare and
					 medicare supplement insurance, review the Guide to Health Insurance for People
					 with Medicare, available from the insurance company.
UNHANDLEDCHAR For help in understanding your health
					 insurance, contact your state insurance department or state health insurance
					 assistance program (SHIP).
[Alternative disclosure statement for policies that pay
					 fixed dollar amounts for specified diseases or other specified impairments.
					 This includes cancer, specified disease, and other health insurance policies
					 that pay a scheduled benefit or specific payment based on diagnosis of the
					 conditions named in the policy.]
Important Notice To Persons on Medicare
This is Not Medicare Supplement Insurance
Some health care services paid for by medicare may also
					 trigger the payment of benefits from this policy.
This insurance pays a fixed amount, regardless of your
					 expenses, if you meet the policy conditions, for one of the specific diseases
					 or health conditions named in the policy. It does not pay your medicare
					 deductibles or coinsurance and is not a substitute for medicare supplement
					 insurance.
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
This policy must pay benefits without regard to other
					 health benefit coverage to which you may be entitled under medicare or other
					 insurance.
Before You Buy This Insurance
UNHANDLEDCHAR Check the coverage in all health insurance
					 policies you already have.
UNHANDLEDCHAR For more information about medicare and
					 medicare supplement insurance, review the Guide to Health Insurance for People
					 with Medicare, available from the insurance company.
UNHANDLEDCHAR For help in understanding your health
					 insurance, contact your state insurance department or state health insurance
					 assistance program (SHIP).
[Alternative disclosure statement for indemnity policies
					 and other policies that pay a fixed dollar amount per day, excluding long-term
					 care policies.]
Important Notice To Persons on Medicare
This is Not Medicare Supplement Insurance
Some health care services paid for by medicare may also
					 trigger the payment of benefits from this policy.
This insurance pays a fixed dollar amount, regardless of
					 your expenses, for each day you meet the policy conditions. It does not pay
					 your medicare deductibles or coinsurance and is not a substitute for medicare
					 supplement insurance.
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
This policy must pay benefits without regard to other
					 health benefit coverage to which you may be entitled under medicare or other
					 insurance.
Before You Buy This Insurance
UNHANDLEDCHAR Check the coverage in all health insurance
					 policies you already have.
UNHANDLEDCHAR For more information about medicare and
					 medicare supplement insurance, review the Guide to Health Insurance for People
					 with Medicare, available from the insurance company.
UNHANDLEDCHAR For help in understanding your health
					 insurance, contact your state insurance department or state health insurance
					 assistance program (SHIP).
[Alternative disclosure statement for policies that provide
					 benefits upon both an expense-incurred and fixed indemnity basis.]
Important Notice To Persons on Medicare
This is Not Medicare Supplement Insurance
Some health care services paid for by medicare may also
					 trigger the payment of benefits from this policy.
This insurance pays limited reimbursement for expenses if
					 you meet the conditions listed in the policy. It also pays a fixed amount,
					 regardless of your expenses, if you meet other policy conditions. It does not
					 pay your medicare deductibles or coinsurance and is not a substitute for
					 medicare supplement insurance.
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
This policy must pay benefits without regard to other
					 health benefit coverage to which you may be entitled under medicare or other
					 insurance. Before You Buy This Insurance
UNHANDLEDCHAR Check the coverage in all health insurance
					 policies you already have.
UNHANDLEDCHAR /bcm For more information about medicare and
					 medicare supplement insurance, review the Guide to Health Insurance for People
					 with Medicare, available from the insurance company.
UNHANDLEDCHAR For help in understanding your health
					 insurance, contact your state insurance department or state health insurance
					 assistance program (SHIP).
[Alternative disclosure statement for other health
					 insurance policies not specifically identified in the preceding
					 statements.]
Important Notice To Persons on Medicare
This is Not Medicare Supplement Insurance
Some health care services paid for by medicare may also
					 trigger the payment of benefits from this policy.
This insurance provides limited benefits if you meet the
					 conditions listed in the policy. It does not pay your medicare deductibles or
					 coinsurance and is not a substitute for medicare supplement insurance.
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
This policy must pay benefits without regard to other
					 health benefit coverage to which you may be entitled under medicare or other
					 insurance.
Before You Buy This Insurance
UNHANDLEDCHAR Check the coverage in all health insurance
					 policies you already have.
UNHANDLEDCHAR For more information about medicare and
					 medicare supplement insurance, review the Guide to Health Insurance for People
					 with Medicare, available from the insurance company.
UNHANDLEDCHAR For help in understanding your health
					 insurance, contact your state insurance department or state health insurance
					 assistance program (SHIP).
In 2010 the revisor of statutes, acting under
						AS
						01.05.031, renumbered former
						AS
						21.89.060 as
						AS
						21.96.060. As of Register 196 (January 2011),
						the regulations attorney made a conforming technical revision under
						AS
						44.62.125(b)(6), to the
						authority citation that follows
						3 AAC 28.502, so that the citation to former
						AS
						21.89.060 now refers to the renumbered
						statute, AS
						21.96.060.
Authority:
AS
						21.06.090
AS 21.42.130
AS
						21.96.060