(e)(i) An enrollment form for specified disease insurance shall include a statement above the signature of the applicant that an individual is not eligible for specified disease insurance if covered by a Title XIX program, designated as Medicaid or any similar name.(ii) The disclaimer may be combined with any other statement for which the insurer may require the applicant's signature.
(f) Payments may be conditioned upon an insured receiving medically necessary care, given in a medically appropriate location, and under a medically accepted course of diagnosis or treatment.
(g) Specified disease insurance benefits shall be paid regardless of other coverage.
(h) After the effective date of the contract, or the conclusion of an applicable probationary period, benefits shall begin with the first day of care or confinement, if such care or confinement is for a covered disease, even though the diagnosis is made at a later date.
(i) Hospice care is an optional benefit that, if offered, shall meet the following standards:
(i) benefits are payable when the attending physician provides a written statement that the insured has a life expectancy of six months or less;
(ii) a fixed-sum payment of at least $50 per day; and
(iii) a lifetime maximum benefit of at least $10,000.
(j) The following standards apply to specified disease insurance issued on an expense-incurred basis:
(i) a deductible amount may not exceed $250;
(ii) an aggregate benefit limit may not be less than $25,000;
(iii) a benefit period may not be less than three years;
(iv) services provided on an outpatient basis may be subject to a copayment that may not exceed 20% of covered services;
(v) covered services shall include:
(A) hospital room and board and any other hospital-furnished medical service or supply;
(B) treatment by, or treatment under the direction of, a physician or surgeon;
(C) private duty nursing services of a registered nurse or licensed practical nurse;
(D) x-ray, radium, chemotherapy, and other therapy procedures used in diagnosis and treatment;
(E) blood transfusions, including the administration and expense incurred for blood donors;
(F) drugs and medicines prescribed by a physician;
(G) professional ambulance for local service to or from a local hospital;
(H) the rental of any respiratory or other mechanical apparatus;
(I) braces, crutches, and wheelchairs as ordered by the physician for the treatment of the disease;
(J) emergency transportation if, in the opinion of the physician, it is necessary to transport the insured to another locality for treatment of the disease;
(K) home health care with a written prescribed plan of care;
(L) physical, speech, hearing, and occupational therapy;
(M) special equipment including a hospital bed, toilette, pulleys, wheelchairs, aspirator, chux, oxygen, surgical dressings, rubber shields, colostomy, and ileostomy appliances;
(N) prosthetic devices including wigs and artificial breasts;
(O) nursing home care for non-custodial services; and
(P) reconstructive surgery when deemed necessary by the physician.
(k) Specified disease insurance offered on a per diem basis shall include covered services for:
(i) hospital confinement benefit with a fixed-sum payment of at least $200 for each day of hospital confinement, for at least 365 days, with no deductible amount permitted;
(ii) outpatient benefit with a fixed-sum payment equal to one-half of the hospital inpatient benefit for each day of hospital or non-hospital outpatient surgery, radiation therapy, and chemotherapy, for at least 365 days of treatment;
(iii) blood and plasma benefit with a fixed-sum benefit of at least $50 per day, that includes their administration whether received as an inpatient or outpatient, for at least 365 days of treatment; and
(iv) benefits tied to confinement in a skilled nursing home or home health care, if offered:
(A) shall include a fixed-sum payment equal to:
(I) one-half of the hospital inpatient benefit for each day of skilled nursing home confinement for at least 180 days; and
(II) a fixed-sum payment equal to one-fourth of the hospital inpatient benefit for each day of home health care for at least 180 days; and
(B) may not include a restriction or limitation applied to the benefits that are more restrictive than those under Medicare.
(l) The following standards apply to specified disease insurance on a lump sum basis:
(i) benefits shall be payable as a fixed, one-time payment made within 30 days of submission to the insurer of proof of diagnosis of the specified disease, and shall be offered for sale only in even increments of $1,000; and
(ii) if coverage is advertised or otherwise represented to offer generic coverage of a disease or diseases, for example "cancer insurance" or "heart disease insurance," the minimum benefit shall be:
(A) the same dollar amount regardless of the subtype of the disease, for example lung or bone cancer; or
