Section 687B.308 - Standardized Benefit Plan EA 1990 standardized benefit plan to supplement Medicare which is designated as Standardized Benefit Plan E must provide the following benefits:
1. The benefits required by NAC 687B.290.2. Coverage for all of the Medicare Part A inpatient hospital deductible amount per benefit period.3. For Medicare Part A eligible expenses for posthospital care received at a skilled nursing facility, coverage for the actual billed charges up to the coinsurance amount from the 21st day through the 100th day in any Medicare benefit period.4. Coverage of Medicare eligible expenses for 80 percent of the billed charges for medically necessary emergency care received in a foreign country to the extent not covered by Medicare, if such care would have been covered by Medicare if provided in the United States and the care began during the first 60 consecutive days of the trip outside the United States. The benefit is subject to the payment of a deductible of $250 per calendar year and a lifetime maximum benefit of $50,000. As used in this subsection, "emergency care" means medical care needed immediately because of a sudden and unexpected injury or illness.5. Coverage for the following preventative health services for the actual amount charged for each service not to exceed 100 percent of the amount approved by Medicare for that service, as identified in the American Medical Association's Current Procedural Terminology (AMA CPT) codes, not to exceed $120 per year, and to the extent not covered by Medicare: (a) An annual clinical medical history and physical examination that may include the tests and services set forth in paragraph (b) and educational services that address measures to be taken for preventative health care.(b) Preventive screening tests or preventive services, the selection and frequency of which is determined to be medically appropriate by the attending physician.Nev. Admin. Code § 687B.308
Added to NAC by Comm'r of Insurance, 7-16-92, eff. 7-30-92; A 5-13-96; R110-98, 2-23-99; 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