| (ii) the lesser of $50 or the Medicare Part B coinsurance
or copayment for each covered emergency room visit; however, this
copayment must be waived if the insured is admitted to any hospital
and the emergency visit is subsequently covered as a Medicare Part
A expense.
(6) An issuer may, with the prior approval of the Commissioner,
offer policies or certificates with new or innovative benefits, in
addition to the standardized benefits provided in a policy or certificate
that otherwise complies with the applicable standards. The new or
innovative benefits may include only benefits that are appropriate
to Medicare supplement insurance, are new or innovative, are not otherwise
available, and are cost effective. Approval of new or innovative benefits
must not adversely impact the goal of Medicare supplement simplification.
New or innovative benefits may not include an outpatient prescription
drug benefit. New or innovative benefits may not be used to change
or reduce benefits, including a change of any cost-sharing provision,
in any standardized plan.
|
| Source Note: The provisions of this §3.3306 adopted to be effective June 1, 1982, 7 TexReg 1303; amended to be effective July 28, 1989, 14 TexReg 3401; amended to be effective February 14, 1990, 15 TexReg 540; amended to be effective July 3, 1990, 15 TexReg 3581; amended to be effective December 1, 1990, 15 TexReg 6594; amended to be effective April 15, 1992, 17 TexReg 2238; amended to be effective January 1, 1997, 21 TexReg 10753; amended to be effective April 14, 1999, 24 TexReg 3353; amended to be effective February 19, 2001 26 TexReg 1544; amended to be effective April 4, 2002, 27 TexReg 2498; amended to beeffectiveMay 10, 2005, 30 TexReg 2669; amended to be effective July 6, 2009, 34 TexReg 4532; amended to be effective June 13, 2018, 43 TexReg 3787 |
