Rhode Island Code of Regulations › Title 230 - Department of Business Regulation › Chapter 20 - Insurance › Subchapter 30 - Health Insurance › Part 7 - Medicare Supplement Insurance Minimum Standards › Section 230-RICR-20-30-7.10 - Standard Medicare Supplement Benefit Plans for 1990 Standardized Medicare Supplement Benefit Plan Policies or Certificates Issued for Delivery on or After July 30, 1992 and with an Effective Date for Coverage Prior to June 1, 2010

Current through June 14, 2024
A. An issuer shall
				  make available to each prospective policyholder and certificate holder a policy
				  form or certificate form containing only the basic core benefits, as defined in
				  §
										7.8(C)   of this Part.
B. No
				  groups, packages or combinations of Medicare supplement benefits other than
				  those listed in this section shall be offered for sale in this state, except as
				  may be permitted in §§
										7.10(G)  and  7.13   of this Part.
C. Benefit plans shall be uniform in
				  structure, language, designation and format to the standard benefit plans "A"
				  through "L" listed in this subsection and conform to the definitions in
				  §
										7.4   of this Part. Each benefit shall be structured in accordance with the
				  format provided in §
										7.8(C), (D) and (E)   of this Part and list the benefits
				  in the order shown in this subsection. For purposes of this Part, "structure,
				  language, and format" means style, arrangement and overall content of a
				  benefit.
D. An issuer may use, in
				  addition to the benefit plan designations required in §
										7.10(C)   of this
				  Part, other designations to the extent permitted by law.
E. Make-up of benefit plans:
1. Standardized Medicare supplement benefit
				  plan "A" shall be limited to the basic (core) benefits common to all benefit
				  plans, as defined in §
											7.8(C)   of this Part.
2. Standardized Medicare supplement benefit
				  plan "B" shall include only the following: The core benefit as defined in
				  §
											7.8(C)   of this Part, plus the Medicare Part A deductible as defined in
				  §
											7.8(D)(1)   of this Part.
3.
				  Standardized Medicare supplement benefit plan "C" shall include only the
				  following: The core benefit as defined in §
											7.8(C)   of this Part, plus the
				  Medicare Part A deductible, skilled nursing facility care, Medicare Part B
				  deductible and medically necessary emergency care in a foreign country as
				  defined in §
											7.8(D)(1), (2), (3) and (8)   of this Part
				  respectively.
4. Standardized
				  Medicare supplement benefit plan "D" shall include only the following: The core
				  benefit (as defined in §
											7.8(C)   of this Part), plus the Medicare Part A
				  deductible, skilled nursing facility care, medically necessary emergency care
				  in an foreign country and the at-home recovery benefit as defined in
				  §
											7.8(D)(1), (2), (8) and (10)   of this Part respectively.
5. Standardized Medicare supplement benefit
				  plan "E" shall include only the following: The core benefit as defined in
				  §
											7.8(C)   of this Part, plus the Medicare Part A deductible, skilled nursing
				  facility care, medically necessary emergency care in a foreign country and
				  preventive medical care as defined in §
											7.8(D)(1), (2), (8) and (9)   of this
				  Part respectively.
6. Standardized
				  Medicare supplement benefit plan "F" shall include only the following: The core
				  benefit as defined in §
											7.8(C)   of this Part, plus the Medicare Part A
				  deductible, the skilled nursing facility care, the Part B deductible, one
				  hundred percent (100%) of the Medicare Part B excess charges, and medically
				  necessary emergency care in a foreign country as defined in §
											7.8(D)(1),
				  (2), (3), (5) and (8)   of this Part respectively.
7. Standardized Medicare supplement benefit
				  high deductible plan "F" shall include only the following: 100% of covered
				  expenses following the payment of the annual high deductible plan "F"
				  deductible. The covered expenses include the core benefit as defined in
				  §
											7.8(C)   of this Part, plus the Medicare Part A deductible, skilled nursing
				  facility care, the Medicare Part B deductible, one hundred percent (100%) of
				  the Medicare Part B excess charges, and medically necessary emergency care in a
				  foreign country as defined in §
											7.8(D)(1), (2), (3), (5) and (8)   of this
				  Part respectively. The annual high deductible plan "F" deductible shall consist
				  of out-of-pocket expenses, other than premiums, for services covered by the
				  Medicare supplement plan "F" policy, and shall be in addition to any other
				  specific benefit deductibles. The annual high deductible Plan "F" deductible
				  shall be $1500 for 1998 and 1999, and shall be based on the calendar year. It
				  shall be adjusted annually thereafter by the Secretary to reflect the change in
				  the Consumer Price Index for all urban consumers for the twelve-month period
				  ending with August of the preceding year, and rounded to the nearest multiple
				  of $10.
8. Standardized Medicare
				  supplement benefit plan "G" shall include only the following: The core benefit
				  as defined in §
											7.8(C)   of this Part, plus the Medicare Part A deductible,
				  skilled nursing facility care, eighty percent (80%) of the Medicare Part B
				  excess charges, medically necessary emergency care in a foreign country, and
				  the at-home recovery benefit as defined in §
											7.8(D)(1), (2), (4), (8) and
				  (10)   of this Part respectively.
9.
				  Standardized Medicare supplement benefit plan "H" shall consist of only the
				  following: The core benefit as defined in §
											7.8(C)   of this Part, plus the
				  Medicare Part A deductible, skilled nursing facility care, basic prescription
				  drug benefit and medically necessary emergency care in a foreign country as
				  defined in §
											7.8(D)(1), (2), (6) and (8)   of this Part respectively. The
				  outpatient prescription drug benefit shall not be included in a Medicare
				  supplement policy sold after December 31, 2005.
10. Standardized Medicare supplement benefit
				  plan "I" shall consist of only the following: The core benefit as defined in
				  §
											7.8(C)   of this Part, plus the Medicare Part A deductible, skilled nursing
				  facility care, one hundred percent (100%) of the Medicare Part B excess
				  charges, basic prescription drug benefit, medically necessary emergency care in
				  a foreign country and at-home recovery benefit as defined in §
											7.8(D)(1),
				  (2), (5), (6), (8) and (10)   of this Part respectively. The outpatient
				  prescription drug benefit shall not be included in a Medicare supplement policy
				  sold after December 31, 2005.
11.
				  Standardized Medicare supplement benefit plan "J" shall consist of only the
				  following: The core benefit as defined in §
											7.8(C)   of this Part, plus the
				  Medicare Part A deductible, skilled nursing facility care, Medicare Part B
				  deductible, one hundred percent (100%) of the Medicare Part B excess charges,
				  extended prescription drug benefit, medically necessary emergency care in a
				  foreign country, preventive medical care and at-home recovery benefit as
				  defined in §
											7.8(D)(1), (2), (3), (5), (7), (8), (9) and (10)   of this Part
				  respectively. The outpatient prescription drug benefit shall not be included in
				  a Medicare supplement policy sold after December 31, 2005.
12. Standardized Medicare supplement benefit
				  high deductible plan "J" shall consist of only the following: 100% of covered
				  expenses following the payment of the annual high deductible plan "J"
				  deductible. The covered expenses include the core benefit as defined in
				  §
											7.8(C)   of this Part, plus the Medicare Part A deductible, skilled nursing
				  facility care, Medicare Part B deductible, one hundred percent (100%) of the
				  Medicare Part B excess charges, extended outpatient prescription drug benefit,
				  medically necessary emergency care in a foreign country, preventive medical
				  care benefit and at-home recovery benefit as defined in §
											7.8(D)(1), (2),
				  (3), (5), (7), (8), (9) and (10)   of this Part respectively. The annual high
				  deductible plan "J" deductible shall consist of out-of-pocket expenses, other
				  than premiums, for services covered by the Medicare supplement plan "J" policy,
				  and shall be in addition to any other specific benefit deductibles. The annual
				  deductible shall be $1500 for 1998 and 1999, and shall be based on a calendar
				  year. It shall be adjusted annually thereafter by the Secretary to reflect the
				  change in the Consumer Price Index for all urban consumers for the twelve-month
				  period ending with August of the preceding year, and rounded to the nearest
				  multiple of $10. The outpatient prescription drug benefit shall not be included
				  in a Medicare supplement policy sold after December 31, 2005.