[Code of Federal Regulations]

[Title 42, Volume 2]

[Revised as of October 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR422.104]



[Page 993]

 

                         TITLE 42--PUBLIC HEALTH

 

                    CHAPTER IV--CENTERS FOR MEDICARE

                          & MEDICAID SERVICES,

                        DEPARTMENT OF HEALTH AND

                             HUMAN SERVICES

 

PART 422_MEDICARE ADVANTAGE PROGRAM--Table of Contents

 

             Subpart C_Benefits and Beneficiary Protections

 

Sec. 422.104  Special rules on supplemental benefits for MA MSA plans.



    (a) An MA organization offering an MA MSA plan may not provide 

supplemental benefits that cover expenses that count towards the 

deductible specified in Sec. 422.103(d).

    (b) In applying the limitation of paragraph (a) of this section, the 

following kinds of policies are not considered as covering the 

deductible:

    (1) A policy that provides coverage (whether through insurance or 

otherwise) for accidents, disability, dental care, vision care, or long-

term care.

    (2) A policy of insurance in which substantially all of the coverage 

relates to liabilities incurred under workers' compensation laws, tort 

liabilities, liabilities relating to use or ownership of property, and 

any other similar liabilities that CMS may specify by regulation.

    (3) A policy of insurance that provides coverage for a specified 

disease or illness or pays a fixed amount per day (or other period) of 

hospitalization.