Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 5 - Regulation 33-Medicare Supplement Insurance Minimum Standards › Section XIII-565 - Requirements for Application Forms and Replacement Coverage

Current through Register Vol. 50, No. 6, June 20, 2024
A. Application
				forms shall include the following questions designed to elicit information as
				to whether, as of the date of the application, the applicant currently has
				Medicare supplement, Medicare Advantage, Medicaid coverage, or any other 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.
B. An
				application for a Medicare supplement policy shall not be combined with an
				application for any other type of insurance coverage. The application may not
				make reference to or include questions regarding other types of insurance
				coverage except for those questions specifically required under this Section.
1. [Statements]
a. You do not need more than one Medicare
				supplement policy.
b. If you
				purchase this policy, you may want to evaluate your existing health coverage
				and decide if you need multiple coverages.
c. You may be eligible for benefits under
				Medicaid and may not need a Medicare supplement policy.
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 24 months. You must request this suspension within
				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 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.
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 90 days of losing your employer or union-based group 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.
f. Counseling services may be available in
				your state 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).