● physician services
● hospice
● [outpatient prescription drugs if you are enrolled in Medicare
Part D]
● other approved items and services
√ Check the coverage in all health insurance policies you already have.
√ For more information about Medicare and Medicare Supplement insurance, review the “Wisconsin Guide to Health Insurance for People with Medicare,” available from the insurance company.
√ For help in understanding your health insurance, contact your state insurance department or state senior insurance counseling program.
(h) [Alternative disclosure statement for other health insurance policies not specifically identified in the preceding statements.]
Some health care services paid for by Medicare may also trigger the payment of benefits from this policy.
This insurance provides limited benefits if you meet the conditions listed in the policy. It does not pay your Medicare deductibles or coinsurance and is not a substitute for Medicare Supplement insurance.
Medicare generally pays for most or all of these expenses.
Medicare pays extensive benefits for medically necessary services regardless of the reason you need them. These include:
● hospitalization
● physician services
● hospice
● [outpatient prescription drugs if you are enrolled in Medicare
Part D]
● other approved items and services
This policy must pay benefits without regard to other health benefit coverage to which you may be entitled under Medicare or other insurance.
√ Check the coverage in all health insurance policies you already have.
√ For more information about Medicare and Medicare Supplement insurance, review the “Wisconsin Guide to Health Insurance for People with Medicare”, available from the insurance company.
√ For help in understanding your health insurance, contact your state insurance department or state senior insurance counseling program.
Ins 3.40Ins 3.40 Coordination of benefits provisions in group and blanket disability insurance policies. Ins 3.40(1)(a)(a) This section establishes authorized coordination of benefits provisions for group and blanket disability insurance policies pursuant to s. 631.23, Stats. It has been found that these clauses are necessary to provide certainty of meaning. Regulation of contract forms will be more effective, and litigation will be substantially reduced if there is uniformity regarding coordination of benefits provisions in health insurance policies. Ins 3.40(1)(b)(b) A Coordination of benefits (COB) provision as defined in sub. (3) (e) avoids claim payment delays be establishing an order in which Plans pay their claims and by providing the authority for the orderly transfer of information needed to pay claims promptly. It avoids duplication of benefits by permitting a reduction of the benefits of a Plan when, by the rules established by this section, a Plan does not have to pay its benefits first. Ins 3.40(1)(c)(c) Coordinating health benefits has been found to be an effective tool in containing health care costs. However, minimum standards of protection and uniformity are needed to protect the insured’s and the public’s interest.