subject: Regulations For Medicare Supplement Insurance Companies [print this page] The government serves as a regulating body in market activities and business transactions. Despite business autonomy, the government has an eye for private companies and corporations. They keep companies in check through trade and commerce laws, business policies, and industry regulations. In the insurance industry, the government controls the purse strings of private companies through government health insurance agencies.
Private insurance companies must be authorized and certified by a government health insurance agency prior to their marketing and operation. They must be able to pass quality control assessment on administrative, medical, technical, and marketing functions. These include sustainability of company operations, extent of administrative capacities, and technical support operations. Private insurance companies must be financially stable to sustain monetary support for the medical services of their policyholders.
Private insurance companies offer and provide Medigap insurance policies. Medigap insurance policies are health insurance plans that offer additional medical benefits. These policies are purchased with Medicare health plans, providing a wide range of network of medical providers for policyholders. Hence, many opt to obtain Medigap health insurance plans. These policies are also called Medicare supplement insurance.
Moreover, Medicare supplement insurance companies are obliged to follow health insurance laws by the federal government. Basically, Medigap insurance policies are composed of 10 options, named as Insurance policy A to Insurance Policy J. Recently, the federal government has passed additional provisions, the Insurance Policy K, L, M, and N. Benefit coverage offered by private companies must be in accord with the standardized medical coverage of health insurance laws. In other words, medical and health coverage of Insurance policy A must be similar in every company, regardless of premium and deductible rate.
Basic benefit coverage of Medicare supplement insurance companies must include provisions in Medicare policy parts A and B. This includes hospital insurance on inpatient hospital confinement, medical tests, and doctors fees. Part B consists of outpatient medical services such as vaccinations, x-rays, laboratory examinations, and diagnostic tests. Government health agencies also require private insurance companies to cover Part D of Medicare policy. This incorporates prescription drug plans.
Medicare supplement insurance companies are prohibited to conduct aggressive marketing campaigns. They are forbidden to contact beneficiaries and policyholders without prior notice. Hence, unsolicited phone calls, e-mails, and postal mails are not allowed. Government health insurance agencies keep an eye on private insurance companies to ensure insurance policies are fairly administered to policyholders.
by: Tyra Phillips
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