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REFERENCE TITLE: medicare supplement;
disability; renal disease |
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State of
Arizona House of
Representatives Fifty-fourth
Legislature Second Regular
Session 2020 |
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HB 2428 |
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Introduced by Representative Butler |
AN ACT
amending section
20-1133, Arizona Revised Statutes; relating to medicare supplement insurance.
(TEXT OF BILL BEGINS ON NEXT PAGE)
Be it enacted by the Legislature of the State of Arizona:
Section 1. Section 20-1133, Arizona Revised Statutes, is amended to read:
20-1133. Medicare supplement insurance; disability; end-stage renal disease; applicability
A. The director shall adopt those rules as are necessary to comply with the requirements of the social security disability amendments of 1980 (P.L. 96‑265; 94 Stat. 441; 42 United States Code section 1395ss) and any federal laws or regulations pertaining to that section, so that this state may retain its full authority to regulate minimum standards for medicare supplement insurance.
B. Subject to the other limitations provided in this subsection, no benefit benefits mandated in this title for health insurance policies shall do not apply to medicare supplement insurance policies unless such mandated policy benefits are set forth in rules adopted pursuant to this section or unless the statute mandating policy benefits expressly states that it is made specifically applicable to medicare supplement insurance policies. No A medicare supplement insurance policy shall not contain any exclusion for services provided by any type of properly licensed health care provider if the provider's services are eligible for medicare reimbursement and if the specific services in question would be covered by medicare. In no event shall The scope of benefits of a medicare supplement policy may not be less than the minimum level of benefits established by federal law.
C. Any insurer that offers medicare
supplement insurance policies in this state to persons who are at least
sixty-five years of age shall also offer medicare supplement insurance policies
to persons who are eligible for and enrolled in medicare due to a disability or
end-stage renal disease. All benefits and coverages that apply to a
medicare enrollee who is at least sixty-five years of age must also apply to a
medicare enrollee who is enrolled due to a disability or end-stage renal
disease.
D. A medicare enrollee may enroll in
a medicare supplement insurance policy at any time allowed or required by
federal law or within six months after any of the following:
1. Enrolling in medicare part B or
January 1, 2021 for an enrollee who is under sixty-five years of age and who is
eligible for medicare due to a disability or end-stage renal disease, whichever
is later.
2. Receiving notice that the enrollee
has been retroactively enrolled in medicare part B due to a retroactive
eligibility decision made by the social security administration.
3. Termination of coverage under a
group health insurance plan.
E. Any premium charged to an enrollee
who qualifies for medicare due to a disability or end-stage renal disease may
not be excessive or unfairly discriminatory compared to the premium charged to an
enrollee who qualifies for medicare due to being at least sixty-five years of
age.
F. A medicare supplement insurance
policy issued pursuant to this section may not prohibit a payment made by a
third party on behalf of an enrollee if full payment is made in a timely manner
as provided in the policy.
C. G. Notwithstanding
any other provision of this title, rules adopted pursuant to this section apply
to insurance furnished under disability insurance policies, under
subscription contracts of hospital, medical, dental or optometric service
corporations, under certificates of fraternal benefit
societies, under evidences of coverage of health care
services organizations and under coverages issued by any
other insurer, which policies, contracts, certificates, membership coverages,
evidences of coverage and coverages are delivered or issued for delivery in
this state on or after the effective date of rules adopted pursuant to subsection
A of this section. In adopting the rules
required by subsection A of this section, the director
shall prescribe an effective date of the rules that will allow insurers
sufficient time to bring their forms and practices into compliance with the
requirements of the rule.