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<regulation prefix="Regulation" num=".06" citation="COMAR 31.10.05.06" title_num="31" subtitle_num="10" chapter_num="05" heading="Prohibited Policy Provisions.">
  <paragraph num="A.">
    <text>Waivers may not be included in or attached to a Medicare supplement policy if the effect of the waivers is to exclude, limit, or reduce coverage or benefits for specifically named or described diseases or physical conditions.</text>
  </paragraph>
  <paragraph num="B.">
    <text>A Medicare supplement policy or subscriber contract may not be advertised, solicited, or issued for delivery in this State as a Medicare supplement policy or subscriber contract if the policy or contract limits or excludes coverage by type of illness, accident, treatment, or medical condition, except for the following, provided however, that if any of the following limitations or exclusions are contained in a Medicare supplement policy, the limitation or exclusion may not be more restrictive than that applicable to the Medicare program:</text>
    <paragraph num="(1)">
      <text>Foot care in connection with corns, calluses, flat feet, fallen arches, weak feet, chronic foot strain, or symptomatic complaints of the feet;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Mental or emotional disorders, alcoholism, and drug addiction;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Illness, treatment, or medical condition arising out of:</text>
      <paragraph num="(a)">
        <text>War or act of war (whether declared or undeclared), participation in a felony, riot or insurrection, service in the armed forces or auxiliary units,</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Suicide while sane or insane, attempted suicide, or intentionally self-inflicted injury, or</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Aviation or air travel other than as a fare-paying passenger on a regularly scheduled airline or on a group-chartered plane;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>Cosmetic surgery, but this exclusion may not apply to reconstructive surgery when the surgery is incidental to or follows surgery resulting from trauma, infection, or diseases of the involved part;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Care in connection with the detection and correction by manual or mechanical means of structural imbalance, distortion, or subluxation in the human body for purposes of removing nerve interference and their effects, if the interference is the result of or related to distortion, misalignment or subluxation of, or in, the vertebral column;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Treatment provided in a federal government hospital, benefits provided under Medicare or other governmental program (except Medicaid), any workers' compensation, employer's liability or occupational disease or similar law, or any motor vehicle no-fault or similar law;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Services rendered by, and separately billed by, the employees of hospitals, laboratories, or other institutions;</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Services performed by a member of the covered person's immediate family, and services for which no charge is normally made in the absence of insurance;</text>
    </paragraph>
    <paragraph num="(9)">
      <text>Dental care or treatment;</text>
    </paragraph>
    <paragraph num="(10)">
      <text>Eyeglasses, hearing aids, and examination for their prescription or fitting;</text>
    </paragraph>
    <paragraph num="(11)">
      <text>Rest cures, custodial care, transportation, and routine physical examinations;</text>
    </paragraph>
    <paragraph num="(12)">
      <text>Territorial limitations outside the United States; and</text>
    </paragraph>
    <paragraph num="(13)">
      <text>Coverage of any expense to the extent of any benefit available to the insured under Medicare.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>The terms “Medicare supplement”, “Medigap”, and words of similar import may not be used in connection with the advertisement, solicitation, or policy description or title unless the policy is issued in compliance with these regulations.</text>
  </paragraph>
  <paragraph num="D.">
    <text>A Medicare supplement policy, contract, or certificate in force in this State may not include benefits which duplicate benefits provided by Medicare.</text>
  </paragraph>
  <paragraph num="E.">
    <text>An insurer may not deny, reduce, or condition coverage or apply an increased premium rating to an applicant for a Medicare supplement policy by reason of the applicant's health status, claims experience, medical condition, or use of medical care if the applicant applies for the Medicare supplement policy within the first 6 months after becoming eligible for Medicare by reason of age. However, the insurer may include a provision with regard to preexisting conditions which complies with Regulation .07B(1) of this chapter.</text>
  </paragraph>
</regulation>