Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 35 - MEDICARE SUPPLEMENT INSURANCE › Section 35-9 - 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 July 13, 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 Section
				8(b) of this
				regulation.
(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
				Section 9(g) and in Section
				10 of this regulation.
(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 Section
				4 of this
				regulation. Each benefit shall be structured in accordance with the format
				provided in Sections
				8(b) and
				8(c), or
				8(d) and list the benefits
				in the order shown in this subsection. For purposes of this section,
				"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 Subsection (c),
				other designations to the extent permitted by law.
(e) Make-up of benefit plans:
(i) Standardized Medicare supplement benefit
				plan "A" shall be limited to the basic (core) benefits common to all benefit
				plans, as defined in Section
				8(b) of this
				regulation.
(ii) Standardized
				Medicare supplement benefit plan "B" shall include only the following: The core
				benefit as defined in Section
				8(b) of this regulation,
				plus the Medicare Part A deductible as defined in Section
				8(c)(i).
(iii) Standardized Medicare supplement
				benefit plan "C" shall include only the following: The core benefit as defined
				in Section
				8(b) of this regulation,
				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 Sections
				8(c)(i), (ii), (iii) and
				(viii) respectively.
(iv)
				Standardized Medicare supplement benefit plan "D" shall include only the
				following: The core benefit (as defined in Section
				8(b) of this regulation),
				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 Sections
				8(c)(i), (ii), (viii) and
				(x) respectively.
(v) Standardized
				Medicare supplement benefit plan "E" shall include only the following: The core
				benefit as defined in Section
				8(b) of this regulation,
				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 Sections
				8(c)(i), (ii), and (ix)
				respectively.
(vi) Standardized
				Medicare supplement benefit plan "F" shall include only the following: The core
				benefit as defined in Section
				8(b) of this regulation,
				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 Sections
				8(c)(i), (ii), (iii), (v)
				and (viii) respectively.
(vii)
				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 Section
				8(b) of this regulation,
				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 Sections
				8(c)(i), (ii), (iii), (v)
				and (viii) 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.
(viii) Standardized
				Medicare supplement benefit plan "G" shall include only the following: The core
				benefit as defined in Section
				8(b) of this regulation,
				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 Sections
				8(c)(i), (ii), (iv),
				(viii), and (x) respectively.
(ix)
				Standardized Medicare supplement benefit plan "H" shall consist of only the
				following: The core benefit as defined in Section
				8(b) of this regulation,
				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 Sections
				8(c)(i), (ii), (vi) and
				(viii) respectively. The outpatient prescription drug benefit shall not be
				included in a Medicare supplement policy sold after December 31,
				2005.
(x) Standardized Medicare
				supplement benefit plan "I" shall consist of only the following: The core
				benefit as defined in Section
				8(b) of this regulation,
				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 Sections
				8(c)(i), (ii), (iv),
				(viii), and (x) respectively. The outpatient prescription drug benefit shall
				not be included in a Medicare supplement policy sold after December 31,
				2005.
(xi) Standardized Medicare
				supplement benefit plan "J" shall consist of only the following: The core
				benefit as defined in Section
				8(b) of this regulation,
				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 Sections
				8(c)(i), (ii), (iii), (v),
				(vi), (viii), (ix), and (x) respectively. The
				outpatient prescription drug benefit shall not be included in a Medicare
				supplement policy sold after December 31, 2005.
(xii) 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 Section
				8(b) of this regulation,
				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 Sections
				8(c)(i), (ii), (iii), (v),
				(vi), (viii), (ix), and (x) 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.