North Dakota Code 26.1-36.1-02 – Standards for Medicare supplement policies
1. The commissioner shall adopt reasonable rules to establish specific standards for provisions of Medicare supplement policies. The standards are in addition to and in accordance with applicable laws of this state, and may include coverage of:
Terms Used In North Dakota Code 26.1-36.1-02
- Contract: A legal written agreement that becomes binding when signed.
- Person: means an individual, organization, government, political subdivision, or government agency or instrumentality. See North Dakota Code 1-01-49
- State: when applied to the different parts of the United States, includes the District of Columbia and the territories. See North Dakota Code 1-01-49
- Statute: A law passed by a legislature.
a. Terms of renewability.
b. Initial and subsequent conditions of eligibility. c. Nonduplication of coverage.
d. Probationary periods.
e. Benefit limitations, exceptions, and reductions. f. Elimination periods.
g. Requirements for replacement.
h. Recurrent conditions. i. Definition of terms.
2. The commissioner may adopt rules that specify prohibited Medicare supplement policy provisions not otherwise specifically authorized by statute which, in the opinion of the commissioner, are unjust, unfair, or unfairly discriminatory to any person insured or proposed for coverage under a Medicare supplement policy or certificate.
3. Notwithstanding any other law, a Medicare supplement policy or certificate may not deny a claim for losses incurred for more than six months from the effective date of coverage for a pre-existing condition. The policy or certificate may not define a pre- existing condition more restrictively than a condition for which medical advice was given or treatment was recommended by or received from a physician within six months before the effective date of coverage.
4. No Medicare supplement insurance policy, contract, or certificate in force in the state may contain benefits that duplicate benefits provided by Medicare.