Washington Administrative Code › Title 284 - Insurance Commissioner, Office of the › Chapter 284-66 - Washington medicare supplement insurance regulation › Section 284-66-060 - Minimum benefit standards

Current through Register Vol. 24-14, July 15, 2024
The requirements of this section apply to medicare supplement
				policies and certificates issued or issued for delivery in this state during
				the period beginning January 1, 1990, and ending June 30, 1992, as well as all
				guaranteed renewable medicare supplement policies delivered to residents of
				this state during 1989 that were modified to meet the minimum benefit standards
				of this section under the Medicare Catastrophic Coverage Act. Minimum standards
				for "standardized" policies and certificates are provided in WAC
				284-66-063.
(1) Coverage of Part A medicare eligible
			 expenses for hospitalization to the extent not covered by medicare from the
			 61st day through the 90th day in any medicare benefit period;
(2) Coverage for either all or none of the
			 medicare Part A inpatient hospital deductible amount;
(3) Coverage of Part A medicare eligible
			 expenses incurred as daily hospital charges during use of medicare's lifetime
			 hospital inpatient reserve days;
(4) Upon exhaustion of all medicare hospital
			 inpatient coverage including the lifetime reserve days, coverage of ninety
			 percent of all medicare Part A eligible expenses for hospitalization not
			 covered by medicare subject to a lifetime maximum benefit of an additional
			 three hundred sixty-five days;
(5)
			 Coverage under medicare Part A for the reasonable cost of the first three pints
			 of blood (or equivalent quantities of packed red blood cells, as defined under
			 federal regulations) unless replaced in accordance with federal regulations or
			 already paid for under Part B;
(6)
			 Coverage for the coinsurance amount of medicare eligible expenses under Part B
			 regardless of hospital confinement, subject to a maximum calendar year
			 out-of-pocket amount equal to the medicare Part B deductible;
(7) Coverage under medicare Part B for the
			 reasonable cost of the first three pints of blood (or equivalent quantities of
			 packed red blood cells, as defined under federal regulations), unless replaced
			 in accordance with federal regulations or already paid for under Part A,
			 subject to the medicare deductible amount.
Statutory Authority:
				  RCW
				  48.02.060 and
				  48.66.165. 05-17-019 (Matter No. R
				  2004-08), §
										284-66-060, filed 8/4/05,
				  effective 9/4/05. Statutory Authority:
				  RCW
				   48.02.060,
				  48.20.450,
				  48.20.460,
				  48.20.470,
				  48.30.010,
				  48.44.020,
				  48.44.050,
				  48.44.070,
				  48.46.030,
				  48.46.130 and
				  48.46.200. 92-06-021 (Order R
				  92-1), §
										284-66-060, filed 2/25/92,
				  effective 3/27/92. Statutory Authority:
				  RCW
				   48.02.060,
				  48.20.450,
				  48.20.460,
				  48.20.470,
				  48.30.010,
				  48.44.020,
				  48.44.050,
				  48.44.070,
				  48.46.030,
				  48.46.130,
				  48.46.200,
				  48.66.041,
				  48.66.050,
				  48.66.100,
				  48.66.110,
				  48.66.120,
				  48.66.130,
				  48.66.150 and
				  48.66.160. 90-07-059 (Order R
				  90-4), §
										284-66-060, filed 3/20/90,
				  effective 4/20/90.