Current through Register No. 12, March 21, 2024
(a) No medicare
supplement policy shall limit or exclude coverage by type of illness, accident,
treatment, or medical condition, except as follows:
(1) Foot care in connection with corns,
calluses, flat feet, fallen arches, weak feet, chronic foot strain, or
symptomatic complaints of the feet;
(2) Alcoholism, drug addiction, and mental or
emotional disorders except as provided in
RSA
415:18-a; RSA 419:5-a; and RSA
420:5-a;
(3) Illness, treatment, or
medical condition arising out of:
a. War or
act of war, whether declared or undeclared;
b. Participation in a felony, riot or
insurrection;
c. Service in the
armed forces or units auxiliary thereto;
d. Suicide, sane or insane, attempted suicide
or intentionally self-inflicted injury;
e. Aviation;
(4) Cosmetic surgery, except that "cosmetic
surgery" shall not include reconstructive surgery when such service is
incidental to or follows surgery resulting from trauma, infection, other
diseases or disorders of the involved part;
(5) Care in connection with the detection and
correction by manual or mechanical means of structural imbalance, distortion,
or subluxation in the human body for purposes of removing nerve interference
and the effects thereof, where such interference is the result of or related to
distortion, misalignment or subluxation of, or in the vertebral
column;
(6) Treatment provided in a
governmental hospital, benefits provided under governmental
program, except Medicaid, any state or federal workers' compensation,
employers' liability or occupational disease law or any motor vehicle no-fault
law, services rendered by employees of hospitals, laboratories or other
institutions, services performed by a member of the covered person's immediate
family and services for which no charge is normally made in the absence of
insurance;
(7) Dental care or
treatment;
(8) Eyeglasses, hearing
aids, and examinations for the prescription or fitting thereof;
(9) Rest cures, custodial care,
transportation, and routine physical examinations; or
(10) Territorial limitations outside the
United States provided, however, medicare supplement policies may not contain,
when issued, limitations or exclusions of the type enumerated in this paragraph
that are more restrictive than those of medicare. Medicare supplement policies
may exclude coverage for any expense to the extent of any benefit available to
the insured under medicare.
(b) No medicare supplement policy may use
waivers to exclude, limit, or reduce coverage or benefits for specifically
named or described preexisting diseases or physical conditions.
(c) No medicare supplement policy shall
include terms which provide that the policy may be cancelled or nonrenewed by
the insurer solely on the grounds of deteriorated health.
(d) The terms "medicare supplement,"
"medigap", and words of similar import shall not be used unless the policy is
issued in compliance with this part.
(e) No medicare supplement insurance policy,
contract, or certificate in force in this state shall contain benefits which
duplicate benefits provided by medicare.
#1900, eff 1-1-82; ss by #4287, eff 7-1-87; ss by #5119,
eff 4-25-91; amd by #5421, eff 7-1-92; ss by #5656, eff 7-1-93; ss by #7017,
INTERIM, eff 7-1-99, EXPIRED: 10-29-99
