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Minnesota Legislature

Office of the Revisor of Statutes

HF 1373

as introduced - 91st Legislature (2019 - 2020) Posted on 02/18/2019 02:16pm

KEY: stricken = removed, old language.
underscored = added, new language.

Current Version - as introduced

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A bill for an act
relating to insurance; making federally conforming changes to supplemental
Medicare coverage; amending Minnesota Statutes 2018, sections 62A.3099, by
adding a subdivision; 62A.31, subdivision 1, by adding a subdivision; 62A.315;
62A.316; 62A.3161; 62A.3162; 62A.3163; 62A.3164; 62A.3165; 62A.318,
subdivision 17; 62E.07.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2018, section 62A.3099, is amended by adding a subdivision
to read:


new text begin Subd. 18a. new text end

new text begin Newly eligible individual. new text end

new text begin "Newly eligible individual" means an individual
who is eligible for Medicare on or after January 1, 2020, because the individual:
new text end

new text begin (1) has attained age 65 on or after January 2020; or
new text end

new text begin (2) is entitled to benefits under Medicare Part A pursuant to section 226(b) or 226A of
the Social Security Act, United States Code, title 42, section 426 or 426-1; or
new text end

new text begin (3) is deemed eligible for benefits under Medicare Part A pursuant to section 226(a) of
the Social Security Act, United States Code, title 42, section 426.
new text end

Sec. 2.

Minnesota Statutes 2018, section 62A.31, subdivision 1, is amended to read:


Subdivision 1.

Policy requirements.

No individual or group policy, certificate, subscriber
contract issued by a health service plan corporation regulated under chapter 62C, or other
evidence of accident and health insurance the effect or purpose of which is to supplement
Medicare coverage, including to supplement coverage under Medicare Advantage plans
established under Medicare Part C, issued or delivered in this state or offered to a resident
of this state shall be sold or issued to an individual covered by Medicare unless the
requirements in subdivisions 1a to deleted text begin1udeleted text endnew text begin 1vnew text end are met.

Sec. 3.

Minnesota Statutes 2018, section 62A.31, is amended by adding a subdivision to
read:


new text begin Subd. 1v. new text end

new text begin Medicare Part B deductible. new text end

new text begin A Medicare supplemental policy or certificate
must not provide coverage for 100 percent or any portion of the Medicare Part B deductible
to a newly eligible individual.
new text end

Sec. 4.

Minnesota Statutes 2018, section 62A.315, is amended to read:


62A.315 EXTENDED BASIC MEDICARE SUPPLEMENT PLAN; COVERAGE.

new text begin (a) new text endThe extended basic Medicare supplement plan must have a level of coverage so that
it will be certified as a qualified plan pursuant to section 62E.07, and will provide:

(1) coverage for all of the Medicare Part A inpatient hospital deductible and coinsurance
amounts, and 100 percent of all Medicare Part A eligible expenses for hospitalization not
covered by Medicare;

(2) coverage for the daily co-payment amount of Medicare Part A eligible expenses for
the calendar year incurred for skilled nursing facility care;

(3) coverage for the coinsurance amount or in the case of hospital outpatient department
services paid under a prospective payment system, the co-payment amount, of Medicare
eligible expenses under Medicare Part B regardless of hospital confinement, and the Medicare
Part B deductible amount;

(4) 80 percent of the usual and customary hospital and medical expenses and supplies
described in section 62E.06, subdivision 1, not to exceed any charge limitation established
by the Medicare program or state law, the usual and customary hospital and medical expenses
and supplies, described in section 62E.06, subdivision 1, while in a foreign country; and
prescription drug expenses, not covered by Medicare. An outpatient prescription drug benefit
must not be included for sale or issuance in a Medicare supplement policy or certificate
issued on or after January 1, 2006;

(5) coverage for the reasonable cost of the first three pints of blood, or equivalent
quantities of packed red blood cells as defined under federal regulations under Medicare
Parts A and B, unless replaced in accordance with federal regulations;

(6) 100 percent of the cost of immunizations not otherwise covered under Part D of the
Medicare program and routine screening procedures for cancer, including mammograms
and pap smears;

(7) preventive medical care benefit: coverage for the following preventive health services
not covered by Medicare:

(i) an annual clinical preventive medical history and physical examination that may
include tests and services from clause (ii) and patient education to address preventive health
care measures;

(ii) preventive screening tests or preventive services, the selection and frequency of
which is determined to be medically appropriate by the attending physician.

Reimbursement shall be for the actual charges up to 100 percent of the Medicare-approved
amount for each service as if Medicare were to cover the service as identified in American
Medical Association current procedural terminology (AMA CPT) codes to a maximum of
$120 annually under this benefit. This benefit shall not include payment for any procedure
covered by Medicare;

(8) coverage of cost sharing for all Medicare Part A eligible hospice care and respite
care expenses; and

(9) coverage for cost sharing for Medicare Part A or B home health care services and
medical supplies.

new text begin (b) An extended basic Medicare supplement plan must provide the benefits contained
in this section, but must not provide coverage for 100 percent or any portion of the Medicare
Part B deductible to a newly eligible individual.
new text end

Sec. 5.

Minnesota Statutes 2018, section 62A.316, is amended to read:


62A.316 BASIC MEDICARE SUPPLEMENT PLAN; COVERAGE.

(a) The basic Medicare supplement plan must have a level of coverage that will provide:

(1) coverage for all of the Medicare Part A inpatient hospital coinsurance amounts, and
100 percent of all Medicare part A eligible expenses for hospitalization not covered by
Medicare, after satisfying the Medicare Part A deductible;

(2) coverage for the daily co-payment amount of Medicare Part A eligible expenses for
the calendar year incurred for skilled nursing facility care;

(3) coverage for the coinsurance amount, or in the case of outpatient department services
paid under a prospective payment system, the co-payment amount, of Medicare eligible
expenses under Medicare Part B regardless of hospital confinement, subject to the Medicare
Part B deductible amount;

(4) 80 percent of the hospital and medical expenses and supplies incurred during travel
outside the United States as a result of a medical emergency;

(5) coverage for the reasonable cost of the first three pints of blood, or equivalent
quantities of packed red blood cells as defined under federal regulations under Medicare
Parts A and B, unless replaced in accordance with federal regulations;

(6) 100 percent of the cost of immunizations not otherwise covered under Part D of the
Medicare program and routine screening procedures for cancer screening including
mammograms and pap smears;

(7) 80 percent of coverage for all physician prescribed medically appropriate and
necessary equipment and supplies used in the management and treatment of diabetes not
otherwise covered under Part D of the Medicare program. Coverage must include persons
with gestational, type I, or type II diabetes. Coverage under this clause is subject to section
62A.3093, subdivision 2;

(8) coverage of cost sharing for all Medicare Part A eligible hospice care and respite
care expenses; and

(9) coverage for cost sharing for Medicare Part A or B home health care services and
medical supplies subject to the Medicare Part B deductible amount.

(b) The following benefit riders must be offered with this plan:

(1) coverage for all of the Medicare Part A inpatient hospital deductible amount;

(2) 100 percent of the Medicare Part B excess charges coverage for all of the difference
between the actual Medicare Part B charges as billed, not to exceed any charge limitation
established by the Medicare program or state law, and the Medicare-approved Part B charge;

(3) coverage for all of the Medicare Part B annual deductible; and

(4) preventive medical care benefit coverage for the following preventative health services
not covered by Medicare:

(i) an annual clinical preventive medical history and physical examination that may
include tests and services from item (ii) and patient education to address preventive health
care measures;

(ii) preventive screening tests or preventive services, the selection and frequency of
which is determined to be medically appropriate by the attending physician.

Reimbursement shall be for the actual charges up to 100 percent of the Medicare-approved
amount for each service, as if Medicare were to cover the service as identified in American
Medical Association current procedural terminology (AMA CPT) codes, to a maximum of
$120 annually under this benefit. This benefit shall not include payment for a procedure
covered by Medicare.

new text begin (c) A basic Medicare supplement plan must provide the benefits contained in this section,
but must not provide coverage for 100 percent or any portion of the Medicare Part B
deductible to a newly eligible individual.
new text end

Sec. 6.

Minnesota Statutes 2018, section 62A.3161, is amended to read:


62A.3161 MEDICARE SUPPLEMENT PLAN WITH 50 PERCENT COVERAGE.

new text begin (a) new text endThe Medicare supplement plan with 50 percent coverage must have a level of coverage
that will provide:

(1) 100 percent of Medicare Part A hospitalization coinsurance plus coverage for 365
days after Medicare benefits end;

(2) coverage for 50 percent of the Medicare Part A inpatient hospital deductible amount
per benefit period until the out-of-pocket limitation is met as described in clause (8);

(3) coverage for 50 percent of the coinsurance amount for each day used from the 21st
through the 100th day in a Medicare benefit period for posthospital skilled nursing care
eligible under Medicare Part A until the out-of-pocket limitation is met as described in
clause (8);

(4) coverage for 50 percent of cost sharing for all Medicare Part A eligible expenses and
respite care until the out-of-pocket limitation is met as described in clause (8);

(5) coverage for 50 percent, under Medicare Part A or B, of the reasonable cost of the
first three pints of blood, or equivalent quantities of packed red blood cells, as defined under
federal regulations, unless replaced according to federal regulations, until the out-of-pocket
limitation is met as described in clause (8);

(6) except for coverage provided in this clause, coverage for 50 percent of the cost
sharing otherwise applicable under Medicare Part B, after the policyholder pays the Medicare
Part B deductible, until the out-of-pocket limitation is met as described in clause (8);

(7) coverage of 100 percent of the cost sharing for Medicare Part B preventive services
and diagnostic procedures for cancer screening described in section 62A.30 after the
policyholder pays the Medicare Part B deductible; and

(8) coverage of 100 percent of all cost sharing under Medicare Parts A and B for the
balance of the calendar year after the individual has reached the out-of-pocket limitation
on annual expenditures under Medicare Parts A and B of $4,000 in 2006, indexed each year
by the appropriate inflation adjustment by the secretary of the United States Department of
Health and Human Services.

new text begin (b) A Medicare supplement plan with 50 percent coverage must provide the benefits
contained in this section, but must not provide coverage for 100 percent or any portion of
the Medicare Part B deductible to a newly eligible individual.
new text end

Sec. 7.

Minnesota Statutes 2018, section 62A.3162, is amended to read:


62A.3162 MEDICARE SUPPLEMENT PLAN WITH 75 PERCENT COVERAGE.

new text begin (a) new text endThe basic Medicare supplement plan with 75 percent coverage must have a level of
coverage that will provide:

(1) 100 percent of Medicare Part A hospitalization coinsurance plus coverage for 365
days after Medicare benefits end;

(2) coverage for 75 percent of the Medicare Part A inpatient hospital deductible amount
per benefit period until the out-of-pocket limitation is met as described in clause (8);

(3) coverage for 75 percent of the coinsurance amount for each day used from the 21st
through the 100th day in a Medicare benefit period for posthospital skilled nursing care
eligible under Medicare Part A until the out-of-pocket limitation is met as described in
clause (8);

(4) coverage for 75 percent of cost sharing for all Medicare Part A eligible expenses and
respite care until the out-of-pocket limitation is met as described in clause (8);

(5) coverage for 75 percent, under Medicare Part A or B, of the reasonable cost of the
first three pints of blood, or equivalent quantities of packed red blood cells, as defined under
federal regulations, unless replaced according to federal regulations until the out-of-pocket
limitation is met as described in clause (8);

(6) except for coverage provided in this clause, coverage for 75 percent of the cost
sharing otherwise applicable under Medicare Part B after the policyholder pays the Medicare
Part B deductible until the out-of-pocket limitation is met as described in clause (8);

(7) coverage of 100 percent of the cost sharing for Medicare Part B preventive services
and diagnostic procedures for cancer screening described in section 62A.30 after the
policyholder pays the Medicare Part B deductible; and

(8) coverage of 100 percent of all cost sharing under Medicare Parts A and B for the
balance of the calendar year after the individual has reached the out-of-pocket limitation
on annual expenditures under Medicare Parts A and B of $2,000 in 2006, indexed each year
by the appropriate inflation adjustment by the Secretary of the United States Department
of Health and Human Services.

new text begin (b) A Medicare supplement plan with 75 percent coverage must provide the benefits
contained in this section, but must not provide coverage for 100 percent or any portion of
the Medicare Part B deductible to a newly eligible individual.
new text end

Sec. 8.

Minnesota Statutes 2018, section 62A.3163, is amended to read:


62A.3163 MEDICARE SUPPLEMENT PLAN WITH 50 PERCENT PART A
DEDUCTIBLE COVERAGE.

new text begin (a) new text endThe Medicare supplement plan with 50 percent Medicare Part A deductible coverage
must have a level of coverage that will provide:

(1) 100 percent of Medicare Part A hospitalization coinsurance plus coverage for 365
days after Medicare benefits end;

(2) coverage for 50 percent of the Medicare Part A inpatient hospital deductible amount
per benefit period;

(3) coverage for the coinsurance amount for each day used from the 21st through the
100th day in a Medicare benefit period for posthospital skilled nursing care eligible under
Medicare Part A;

(4) coverage for cost sharing for all Medicare Part A eligible hospice and respite care
expenses;

(5) coverage under Medicare Part A or B for the reasonable cost of the first three pints
of blood, or equivalent quantities of packed red blood cells, as defined under federal
regulations;

(6) coverage for 100 percent of the cost sharing otherwise applicable under Medicare
Part B, after the policyholder pays the Medicare Part B deductible;

(7) coverage of 100 percent of the cost sharing for Medicare Part B preventive services
and diagnostic procedures for cancer screening described in section 62A.30 after the
policyholder pays the Medicare Part B deductible;

(8) coverage of 80 percent of the hospital and medical expenses and supplies incurred
during travel outside of the United States as a result of a medical emergency; and

(9) coverage for 100 percent of the Medicare Part A or B home health care services and
medical supplies after the policyholder pays the Medicare Part B deductible.

new text begin (b) A Medicare supplement plan with 50 percent Part A deductible coverage must provide
the benefits contained in this section, but must not provide coverage for 100 percent or any
portion of the Medicare Part B deductible to a newly eligible individual.
new text end

Sec. 9.

Minnesota Statutes 2018, section 62A.3164, is amended to read:


62A.3164 MEDICARE SUPPLEMENT PLAN WITH $20 AND $50 CO-PAYMENT
MEDICARE PART B COVERAGE.

new text begin (a) new text endThe Medicare supplement plan with $20 and $50 co-payment Medicare Part B
coverage must have a level of coverage that will provide:

(1) 100 percent of Medicare Part A hospitalization coinsurance plus coverage for 365
days after Medicare benefits end;

(2) coverage for the Medicare Part A inpatient hospital deductible amount per benefit
period;

(3) coverage for the coinsurance amount for each day used from the 21st through the
100th day in a Medicare benefit period for posthospital skilled nursing care eligible under
Medicare Part A;

(4) coverage for the cost sharing for all Medicare Part A eligible hospice and respite
care expenses;

(5) coverage for Medicare Part A or B of the reasonable cost of the first three pints of
blood, or equivalent quantities of packed red blood cells, as defined under federal regulations,
unless replaced according to federal regulations;

(6) coverage for 100 percent of the cost sharing otherwise applicable under Medicare
Part B except for the lesser of $20 or the Medicare Part B coinsurance or co-payment for
each covered health care provider office visit and the lesser of $50 or the Medicare Part B
coinsurance or co-payment for each covered emergency room visit; however, this co-payment
shall be waived if the insured is admitted to any hospital and the emergency visit is
subsequently covered as a Medicare Part A expense;

(7) coverage of 100 percent of the cost sharing for Medicare Part B preventive services
and diagnostic procedures for cancer screening described in section 62A.30 after the
policyholder pays the Medicare Part B deductible;

(8) coverage of 80 percent of the hospital and medical expenses and supplies incurred
during travel outside of the United States as a result of a medical emergency; and

(9) coverage for Medicare Part A or B home health care services and medical supplies
after the policyholder pays the Medicare Part B deductible.

new text begin (b) A Medicare supplement plan with $20 and $50 co-payment Medicare Part B coverage
must provide the benefits contained in this section, but must not provide coverage for 100
percent or any portion of the Medicare Part B deductible to a newly eligible individual.
new text end

Sec. 10.

Minnesota Statutes 2018, section 62A.3165, is amended to read:


62A.3165 MEDICARE SUPPLEMENT PLAN WITH HIGH DEDUCTIBLE
COVERAGE.

new text begin (a) new text endThe Medicare supplement plan will pay 100 percent coverage upon payment of the
annual high deductible. The annual deductible shall consist of out-of-pocket expenses, other
than premiums, for services covered. This plan must have a level of coverage that will
provide:

(1) 100 percent of Medicare Part A hospitalization coinsurance plus coverage for 365
days after Medicare benefits end;

(2) coverage for 100 percent of the Medicare Part A inpatient hospital deductible amount
per benefit period;

(3) coverage for 100 percent of the coinsurance amount for each day used from the 21st
through the 100th day in a Medicare benefit period for posthospital skilled nursing care
eligible under Medicare Part A;

(4) coverage for 100 percent of cost sharing for all Medicare Part A eligible expenses
and respite care;

(5) coverage for 100 percent, under Medicare Part A or B, of the reasonable cost of the
first three pints of blood, or equivalent quantities of packed red blood cells, as defined under
federal regulations, unless replaced according to federal regulations;

(6) except for coverage provided in this clause, coverage for 100 percent of the cost
sharing otherwise applicable under Medicare Part B;

(7) coverage of 100 percent of the cost sharing for Medicare Part B preventive services
and diagnostic procedures for cancer screening described in section 62A.30 after the
policyholder pays the Medicare Part B deductible;

(8) coverage of 100 percent of the hospital and medical expenses and supplies incurred
during travel outside of the United States as a result of a medical emergency;

(9) coverage for 100 percent of Medicare Part A and B home health care services and
medical supplies; and

(10) the basis for the deductible shall be $1,860 and shall be adjusted annually from
2010 by the secretary of the United States Department of Health and Human Services to
reflect the change in the Consumer Price Index for all urban consumers for the 12-month
period ending with August of the preceding year, and rounded to the nearest multiple of
$10.

new text begin (b) A Medicare supplement plan with high deductible coverage must provide the benefits
contained in this section, but must not provide coverage for 100 percent or any portion of
the Medicare Part B deductible to a newly eligible individual.
new text end

Sec. 11.

Minnesota Statutes 2018, section 62A.318, subdivision 17, is amended to read:


Subd. 17.

Types of plans.

new text begin(a) new text endMedicare select policies and certificates offered by the
issuer must provide the coverages specified in sections 62A.315 to 62A.3165. Before a
Medicare select policy or certificate is sold or issued in this state, the applicant must be
provided with an explanation of coverage for each of the coverages specified in sections
62A.315 to 62A.3165 and must be provided with the opportunity of purchasing such coverage
if offered by the issuer. The basic plan may also include any of the optional benefit riders
authorized by section 62A.316. Preventive care provided by Medicare select policies or
certificates must be provided as set forth in section 62A.315 or 62A.316, except that the
benefits are as defined in chapter 62D.

new text begin (b) Medicare select policies and certificates must provide the benefits contained in this
section, but must not provide coverage for 100 percent or any portion of the Medicare Part
B deductible to a newly eligible individual.
new text end

Sec. 12.

Minnesota Statutes 2018, section 62E.07, is amended to read:


62E.07 QUALIFIED MEDICARE SUPPLEMENT PLAN.

new text begin (a) new text endAny plan which provides benefits may be certified as a qualified Medicare supplement
plan if the plan is designed to supplement Medicare and provides coverage of 100 percent
of the deductibles required under Medicarenew text begin, with exclusion under paragraph (b) for any part
of the Medicare Part B deductible,
new text end and 80 percent of the charges for covered services
described in section 62E.06, subdivision 1, which charges are not paid by Medicare. The
coverage shall include a limitation of $1,000 per person on total annual out-of-pocket
expenses for the covered services.

new text begin (b) Any plan sold or issued to a newly eligible individual, as defined in section 62A.3099,
subdivision 18a, that provides benefits may be certified as a qualified Medicare supplemental
plan if the plan is designed to supplement Medicare and provides coverage of 100 percent
of the deductibles, with the exception of coverage of:
new text end

new text begin (1) 100 percent or any portion of the Medicare Part B deductible; and
new text end

new text begin (2) 80 percent of the charges for covered services, as provided under section 62E.06,
subdivision 6, that are charges not paid by Medicare.
new text end

new text begin The coverage must include a $1,000 per person limitation on total annual out-of-pocket
expenses for the covered services.
new text end

Sec. 13. new text beginEFFECTIVE DATE.
new text end

new text begin Sections 1 to 12 are effective the day following final enactment. The coverage
requirements provided by this act in sections 1 to 12 apply to Medicare supplemental policies
or certificates sold or issued on or after January 1, 2020, to a newly eligible individual.
new text end