Michigan Compiled Laws
218-1956-38 - Chapter 38 Medicare Supplement Policies and Certificates (500.3801...500.3861)
Section 500.3823 - Covered Benefits More Restrictive Than Benefits Under Medicare and Required Under State Law Prohibited; Benefits for Outpatient Prescription Drugs.

Sec. 3823.
(1) An insurance policy shall not be titled, advertised, solicited, or issued for delivery in this state as a medicare supplement policy unless the definitions and terms contained in the policy are such that covered benefits under the policy are not more restrictive than covered benefits under medicare and those required to be provided under state law.
(2) A medicare supplement policy with benefits for outpatient prescription drugs in existence prior to January 1, 2006 shall be renewed for current policyholders who do not enroll in part D at the option of the policyholder.
(3) A medicare supplement policy with benefits for outpatient prescription drugs shall not be issued after December 31, 2005.
(4) After December 31, 2005, a medicare supplement policy 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 coverage for expenses of outpatient prescription drugs incurred after the effective date of the individual's coverage under a part D plan.
(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.
History: Add. 1992, Act 84, Imd. Eff. June 2, 1992 ;-- Am. 2006, Act 462, Imd. Eff. Dec. 20, 2006 Popular Name: Act 218

Structure Michigan Compiled Laws

Michigan Compiled Laws

Chapter 500 - Insurance Code of 1956

Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)

218-1956-38 - Chapter 38 Medicare Supplement Policies and Certificates (500.3801...500.3861)

Section 500.3801 - Chapter; Definitions.

Section 500.3803 - Applicability of Chapter.

Section 500.3804 - Repealed. 2018, Act 429, Eff. Mar. 20, 2019.

Section 500.3805 - Medicare Supplement Policy; Definitions.

Section 500.3807 - Basic Core Package of Benefits; Standards for Plans K and L; Applicability of Section.

Section 500.3807a - Medicare Supplement Policies or Certificates With Effective Date for Coverage on or After June 1, 2010; Basic Core Package of Benefits.

Section 500.3808 - Repealed. 2018, Act 429, Eff. Mar. 20, 2019.

Section 500.3809 - Additional Benefits; Reimbursement for Preventive Screening Tests and Services; Definitions; Applicability of Section.

Section 500.3809a - Medicare Supplement Policies or Certificates With Effective Date for Coverage on or After June 1, 2010; Additional Benefits.

Section 500.3811 - Basic Core Benefits; Availability; Sale of Certain Benefits Prohibited; Designations, Structure, Language, and Format; Other Designations; Requirements; Applicability of Section.

Section 500.3811a - Medicare Supplement Policies or Certificates With Effective Date for Coverage on or After June 1, 2010; Basic Core Benefits; Availability; Sale of Certain Benefits Prohibited; Structure, Language, Designation, and Format; Other De...

Section 500.3811b - Medicare Supplement Policies or Certificates for Newly Eligible Individuals After December 31, 2019; Exceptions to Standards and Requirements.

Section 500.3813 - Disability Coverage; Medicare Supplement Buyer's Guide; Applicability of Section.

Section 500.3815 - Outline of Coverage; Acknowledgment of Receipt; Compliance With Notice Requirements; Substitute; Language, Written or Electronic Format, and Required Items.

Section 500.3817 - Medicare Select Policies and Certificates; Definitions; Requirements for Issuance; Plan of Operation; Filing, Format, and Contents; Proposed Changes; Updated List of Network Providers; Payment for Covered Services Not Available Thr...

Section 500.3819 - Minimum Standards; Suspension of Benefits and Premiums; Notice; Reinstitution; Offer to Exchange 1990 Standardized Plan to 2010 Plan.

Section 500.3819a - Medicare Supplement Policies or Certificates With Effective Date for Coverage on or After June 1, 2010; Minimum Standards.

Section 500.3821 - Issuance of Policy to Person Not Enrolled in Medicare Parts a and B Prohibited; Refund; Interest.

Section 500.3823 - Covered Benefits More Restrictive Than Benefits Under Medicare and Required Under State Law Prohibited; Benefits for Outpatient Prescription Drugs.

Section 500.3825 - Preexisting Diseases or Conditions; Waiver Prohibited.

Section 500.3827 - Duplicate Benefits Prohibited; Application; Statements and Questions Whether Another Policy in Force; List of Policies Sold to Applicant; Notice Regarding Replacement Coverage.

Section 500.3829 - Denying or Conditioning Issuance Based on Health Status, Claims Experience, Receipt of Health Care, or Medical Condition of Applicant Prohibited; Condition; Exclusion of Benefits Based on Preexisting Conditions; Reduction; Creditab...

Section 500.3829a - Medicare Supplement Policies or Certificates Delivered, Issued for Delivery, or Renewed on or After May 21, 2009; Genetic Test; Definitions.

Section 500.3830 - Eligible Person; Requirements.

Section 500.3830a - Termination of Contract or Agreement; Notice to Individual.

Section 500.3831 - Individual or Group Expense Incurred Hospital, Medical, or Surgical Policies; Right of Continuation or Conversion to Medicare Supplemental Plan; Request for Coverage; Exclusion From Preexisting Conditions; Notice of Availability of...

Section 500.3833 - Replacement Policy; Waiver of Certain Time Periods.

Section 500.3835 - Marketing Procedures; Determining Appropriateness of Recommended Purchase or Replacement; More Than 1 Policy Prohibited; Individual Enrolled in Medicare Advantage; "Notice to Buyer" Displayed.

Section 500.3837 - Repealed. 2002, Act 304, Imd. Eff. May 10, 2002.

Section 500.3839 - Renewal or Continuation Provision; Effect of Termination or Replacement; Elimination of Outpatient Prescription Drug Benefit.

Section 500.3841 - Riders or Endorsements; Signed Acceptance or Agreement; Additional Premium; Use of Certain Standards, Terms, and Words; Filing of Changes in Medicare Benefits; Elimination of Duplicate Benefits; Notice of Modifications; Notice Requ...

Section 500.3843 - Health Insurance; Notice; Contents; Applicability of Subsection (1).

Section 500.3847 - Advertising; Filing Copy With Director.

Section 500.3849 - Filing and Approval Requirements; Deletion of Outpatient Prescription Drug Benefits; Issuance of Policy; Use and Change in Premium Rates; Additional Forms; Availability; Conditions and Effect of Discontinuance; Combining Forms for...

Section 500.3851 - Aggregate Benefits; Rates, Rating Schedules, and Rate Revisions.

Section 500.3852 - Benchmark Ratio.

Section 500.3853 - Refund or Credit Calculation; Form; Interest; Due Date.

Section 500.3855 - Annual Filing of Rates, Rating Schedule, and Supporting Documentation; Premium Adjustments; Public Hearing for Rate Increase; Failure to Make Premium Adjustments.

Section 500.3857 - Duties of Insurer; Certification of Compliance With Subsection (1)(a).

Section 500.3859 - Prohibited Conduct; Violation as Misdemeanor; Penalty.

Section 500.3861 - Probable Cause of Violation; Notice of Hearing; Opportunity to Confer and Discuss; Hearing; Applicability of MCL 500.2038 to 500.2040; Violation; Penalty.