19 MAC Pt. 3, R. 10.09.2
Standard Medicare Supplement Benefit Plans for 2020 Standardized Medicare
Cite as 19 Miss. Admin. Code Pt. 3, R. 10.09.2
Standard Medicare Supplement Benefit Plans for 2020 Standardized Medicare
Supplement Benefit Plan Policies or Certificates Issued for Delivery to Individuals Newly Eligible
for Medicare on or After January 1, 2020.
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) requires the following
standards are applicable to all Medicare supplement policies or certificates delivered or issued for
delivery in this state to individuals newly eligible for Medicare on or after January 1, 2020. No
policy or certificate that provides coverage of the Medicare Part B deductible may be advertised,
solicited, delivered or issued for delivery in this state as a Medicare supplement policy or certificate
to individuals newly eligible for Medicare on or after January 1, 2020. All policies must comply
with the following benefit standards. Benefit plan standards applicable to Medicare supplement
policies and certificates issued to individuals eligible for Medicare before January 1, 2020, remain
subject to the requirements of Miss. Code Ann. § 83-9-101 to 115, and this regulation.
A.
Benefit Requirements. The standards and requirements of Rule 10.09.1
shall apply to all Medicare supplement policies or certificates delivered or
issued for delivery to individuals newly eligible for Medicare on or after
January 1, 2020, with the following exceptions:
1. Standardized Medicare supplement benefit Plan C is redesignated as
Plan D and shall provide the benefits contained in Rule 10.09.1E(3)
of this regulation but shall not provide coverage for one hundred
percent (100%) or any portion of the Medicare Part B deductible.
2. Standardized Medicare supplement benefit Plan F is redesignated as
Plan G and shall provide the benefits contained in Rule 10.09.1E(5) of
this regulation but shall not provide coverage for one hundred percent
(100%) or any portion of the Medicare Part B deductible.
3. Standardized Medicare supplement benefit plans C, F, and F with High
Deductible may not be offered to individuals newly eligible for
Medicare on or after January 1, 2020.
4. Standardized Medicare supplement benefit Plan F With High Deductible
is redesignated as Plan G With High Deductible and shall provide
the benefits contained in Rule 10.09.1E(6) of this regulation but shall
not provide coverage for one hundred percent (100%) or any portion of
the Medicare Part B deductible; provided further that, the Medicare Part
B deductible paid by the beneficiary shall be considered an out-of-
pocket expense in meeting the annual high deductible.
5.
The reference to Plans C or F contained in Rule 10.09.1A(2) is deemed a
reference to Plans D or G for purposes of this section.
B.
Applicability to Certain Individuals. This Rule 10.09.2, applies to only
individuals that are newly eligible for Medicare on or after January 1, 2020:
1. By reason of attaining age 65 on or after January 1, 2020; or
2. By reason of entitlement to benefits under part A pursuant to Section 226(b) or
226A of the Social Security Act, or who is deemed to be eligible for benefits
under Section 226(a) of the Social Security Act on or after January 1, 2020.
C.
Guaranteed Issue for Eligible Persons. For purposes of Rule 10.12E, in the
case of any individual newly eligible for Medicare on or after January 1, 2020,
any reference to a Medicare supplement policy C or F (including F With High
Deductible) shall be deemed to be a reference to Medicare supplement policy D
or G (including G With High Deductible), respectively, that meet the
requirements of this Rule 10.09.2A.
D.
Applicability to Waivered States. In the case of a State described in Section
1882(p)(6) of the Social Security Act (“waivered” alternative simplification
states) MACRA prohibits the coverage of the Medicare Part B deductible for
any Medicare supplement policy sold or issued to an individual that is newly
eligible for Medicare on or after January 1, 2020.
E. Offer of Redesignated Plans to Individuals Other Than Newly Eligible. On or
after January 1, 2020, the standardized benefit plans described in Subparagraph
A(4), above may be offered to any individual who was eligible for Medicare
prior to January 1, 2020, in addition to the standardized plans described in Rule
10.09.1E of this regulation.