Montana Code 33-22-923. Replacement policy or certificate — different insurer
33-22-923. Replacement policy or certificate — different insurer. (1) If a disability insurer replaces a medicare supplement policy or certificate, it may not deny benefits under the replacing policy or certificate to an insured who receives treatment for a condition that was a covered expense under the replaced policy or certificate and is a covered expense under the replacing policy or certificate if the insured pays the premium for the replacing policy or certificate when due or within 31 days after the termination of the replaced policy or certificate.
Terms Used In Montana Code 33-22-923
- Certificate: means a certificate delivered or issued for delivery in this state under a group medicare supplement policy. See Montana Code 33-22-903
- Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
- Medicare: means Health Insurance for the Aged, Title XVIII of the Social Security Amendments of 1965, as then constituted or later amended. See Montana Code 33-22-903
- Medicare supplement policy: means a group or individual policy of disability insurance or a subscriber contract of a health service corporation, other than a policy issued pursuant to a contract under 42 U. See Montana Code 33-22-903
- Person: includes a corporation or other entity as well as a natural person. See Montana Code 1-1-201
(2)An insurer who replaces a medicare supplement policy or certificate shall base its premium for the replacement policy or certificate on the rates currently in place for that policy or certificate.
(3)If the insured has not satisfied the preexisting condition limitation under the replaced medicare supplement policy or certificate, any period of time that was covered by that policy or certificate must be credited toward the preexisting condition limitation period of the replacing policy or certificate.
(4)To receive the benefits of subsections (1) through (3), a person shall submit to the replacing insurer proof of prior coverage, evidence of benefits provided under the previous policy or certificate, and the effective date and the date of termination of coverage under the previous policy or certificate.