Section 687B.220 - Exclusions from and limitations on coverage and benefits; duplication of benefits provided by Medicare; benefits for outpatient prescription drugs1. Except as otherwise provided in paragraphs (a) and (b) of subsection 2 of NAC 687B.226 and paragraphs (a) and (b) of subsection 2 of NAC 687B.227, and subparagraphs (1) and (2) of paragraph (a) of subsection 2 of NAC 687B.322, a policy or certificate may not be advertised, solicited or issued for delivery in this State as a policy to supplement Medicare if the policy or certificate contains limitations or exclusions on coverage that are more restrictive than those of Medicare.2. A policy to supplement Medicare or a certificate must not use a waiver to exclude, limit or reduce coverage or benefits for specifically named or described preexisting diseases or physical conditions.3. A policy to supplement Medicare or a certificate must not contain benefits that duplicate the benefits provided by Medicare.4. A policy to supplement Medicare with benefits for outpatient prescription drugs in existence before January 1, 2006, must be renewed for current policyholders who do not enroll in Medicare Part D at the option of the policyholder.5. A policy to supplement Medicare with benefits for outpatient prescription drugs must not be issued after December 31, 2005.6. After December 31, 2005, a policy to supplement Medicare with benefits for outpatient prescription drugs may not be renewed after the policyholder enrolls in Medicare Part D unless:(a) The policy is modified to eliminate outpatient prescription drug coverage for expenses of outpatient prescription drugs incurred after the effective date of the person's coverage under a Medicare Part D plan; and(b) Premiums are adjusted to reflect the elimination of outpatient prescription drug coverage at the time of Medicare Part D enrollment, accounting for any claims paid, if applicable.Nev. Admin. Code § 687B.220
Added to NAC by Comm'r of Insurance, 2-21-89, eff. 3-15-89; A 11-16-90; 7-16-92, eff. 7-30-92; 8-2-94; A by Div. of Insurance by R078-05, 11-17-2005, eff. 9-8-2005 for Plans K and L, and 1-1-2006 for Medicare Part D Prescription Drug Benefit; A by Comm'r of Insurance by R049-09, 10-27-2009