HEARING - U.S. Senate Special Committee on Aging

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To ensure that all of these controls are adequate, an NAIC subcsmmittee
recently surveyed state insurance departments regarding citizens' complaints
related to Meadigap insurance. This survey indicated that the limited number
of camplaints were not the result of any deficiency in NA1C model laws.
This same type of process outlined tor Medicare Supplement in protecting
the aged is being unoertaken by the insurance industry and the NAIC regarding
private long term care insurance. Qarrent efforts center upon developing
regulations that will appropriately control the marketplace, yet facilitate
experimentation and exploration of what consurers want to purchase in the long
term care field.
WHAT MEDIGAP POLICIE5 COVER
Private Medicare Supplemental policies typically cover such out-of-pocket
costs under Medicare as co-payments and deductibles for hespital and doctor
services. In keeping with the Baucus Andeent to the 1980 Social Security
Disability Act (P.L. 96-265), the states now recpre Medicare Supplement
policies to meet certain minimum standards, as follows:
- Coverage of Part A coinsurance for Medicare eligible expenses for hospi-
talization from the 61st day through the 9Cth day in any Medicare benefit
period;
- Cverage of Part A coinsurance for Medicare eligible expenses incurred
during use of Medicare's lifetime hospital inpatient reserve days;