S.D. Admin. R. 46:30:08:10

Current through Register Vol. 51, page 56, November 4, 2024
Section 46:30:08:10 - Coverage limits - Insured

An eligible applicant who is covered by any health insurance plan or third party payor may only receive funds for those amounts incurred and payable by the covered person under the deductible and coinsurance provisions of a health plan which are for the covered services listed in § 46:30:08:03.

Expenses for any service authorized in this chapter that is not covered or not payable by the applicant's own health insurance plan for some reason other than the deductible and coinsurance provisions in the health insurance plan are not eligible for coverage under this chapter.

The division may not pay for any portion of the costs of covered services listed in § 46:30:08:03 that are covered by a health insurance plan or otherwise covered under another plan of insurance. Payment pursuant to this chapter is secondary to any other insurance covering or providing reimbursement for the covered services listed in § 46:30:08:03.

S.D. Admin. R. 46:30:08:10

32 SDR 32, effective 8/29/2005.

General Authority: SDCL 49-31-50.2.

Law Implemented: SDCL 49-31-50, 49-31-50.1, 49-31-51.