- (1) Except for permitted preexisting condition clauses as described in paragraphs 69O-156.006(1)(b), 69O-156.007(1)(a), and 69O-156.0075(1)(a), F.A.C., of this chapter, no policy or certificate may be advertised, solicited or issued for delivery in this State as a Medicare supplement policy if such policy or certificate contains limitations or exclusions on coverage that are more restrictive than those of Medicare.
- (2) No Medicare supplement policy or certificate may use waivers to exclude, limit or reduce coverage or benefits for specifically named or described preexisting diseases or physical conditions.
- (3) No Medicare supplement policy or certificate in force in the State shall contain benefits which duplicate benefits provided by Medicare.
- (4) (a) Subject to paragraphs 69O-156.006(1)(e), (f), and (h), and paragraphs 69O-156.007(1)(d) and (e), F.A.C., 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.
- (b) A Medicare supplement policy with benefits for outpatient prescription drugs shall not be issued after December 31, 2005.
(c) 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:
1. 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; and
2. 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.
Rulemaking Authority 624.308(1), 627.674(2) FS. Law Implemented 624.307(1), 627.674(2) FS. History–New 1-1-81, Formerly 4-51.04, Amended 9-4-89, Formerly 4-51.004, Amended 1-1-92, Formerly 4-156.005, Amended 9-15-05, 1-4-10.