Ins 3.39(5t)(h)5.5. Coverage for 75% of the Medicare Part A inpatient hospital deductible amount per benefit period until the out-of-pocket limitation as described in subd. 12. is met. Ins 3.39(5t)(h)6.6. Coverage for 75% of the coinsurance or copayment amount for each day used from the 21st day through the 100th day in a Medicare benefit period for post-hospital skilled nursing facility care eligible under Medicare Part A until the out-of-pocket limitation as described in subd. 12. is met. Ins 3.39(5t)(h)7.7. Coverage for 75% of cost sharing for all Medicare Part A eligible expenses and respite care until the out-of-pocket limitation as described in subd. 12. is met. Ins 3.39(5t)(h)8.8. Coverage for 75%, under Medicare Part A or B, of the reasonable cost of the first 3 pints of blood, or equivalent quantities of packed red blood cells, as defined under federal regulations, unless replaced in accordance with federal regulations until the out-of-pocket limitation as described in subd. 12. is met. Ins 3.39(5t)(h)9.9. Except for coverage provided in subd. 11., coverage for 75% of the cost sharing otherwise applicable under Medicare Part B, after the policyholder or certificateholder pays the Medicare Part B deductible until the out-of-pocket limitation as described in subd. 12. is met. Ins 3.39(5t)(h)10.10. Coverage for 100% of the cost sharing for the benefits described in pars. (d) 1., 6., 7., 9., 14., 16., and 17. and (e) 3., to the extent the benefits do not duplicate benefits paid by Medicare and after the policyholder or certificateholder pays the Medicare Part A and B deductible and the out-of-pocket limitation described in subd. 12. is met. Ins 3.39(5t)(h)11.11. Coverage for 100% of the cost sharing for Medicare Part B preventive services after the policyholder or certificateholder pays the Medicare Part B deductible. Ins 3.39(5t)(h)12.12. Coverage for 100% of all cost sharing under Medicare Parts A and B for the balance of the calendar year after the individual has reached the out-of-pocket limitation on annual expenditures under Medicare Parts A and B indexed each year by the appropriate inflation adjustment specified by the secretary. Ins 3.39(5t)(k)(k) For the Medicare supplement high deductible plan, all of the following shall be included: Ins 3.39(5t)(k)1.1. The designation: MEDICARE SUPPLEMENT INSURANCE-HIGH DEDUCTIBLE PLAN. Ins 3.39(5t)(k)3.3. The annual high deductible shall consist of out-of-pocket expenses, other than premiums, for services covered in subd. 2 and shall be in addition to any other specific benefit deductibles. Ins 3.39(5t)(k)4.4. The annual high deductible shall be $2,000 and shall be adjusted annually by the secretary to reflect the change in the Consumer Price Index for all urban consumers for the 12-month period ending with August of the preceding year, and rounded to the nearest multiple of $10. Ins 3.39(5t)(L)(L) Nothing in this section shall be construed to prohibit an insurer from discontinuing the marketing of policies offered under sub. (5m), (5t), (7), (30m), or (30t). Ins 3.39(6)(6) Usual, customary and reasonable charges. An issuer can only include a policy or certificate provision limiting benefits to the usual, customary and reasonable charge as determined by the issuer for coverages described in sub. (5) (c) 5., 8. and 13., (5m) (d) 6., 9., and 14., or (5t) (d) 6., 9., and 14. If the issuer includes such a provision, the issuer shall: Ins 3.39(6)(a)(a) Define those terms in the policy or rider and disclose to the policyholder that the UCR charge may not equal the actual charge, if this is true. Ins 3.39(6)(b)(b) Have reasonable written standards based on similar services rendered in the locality of the provider to support benefit determination which shall be made available to the commissioner on request. Ins 3.39(7)(7) Authorized Medicare cost policy designation, captions and required minimum coverages. Ins 3.39(7)(a)(a) A Medicare cost policy that is issued by an issuer that has a cost contract with CMS for Medicare benefits shall meet the standards and requirements of sub. (4) and shall contain all of the following required coverages, to be referred to as “Basic Medicare cost coverage” for a policy issued to persons first eligible for Medicare after January 1, 2005, and prior to June 1, 2010: Ins 3.39(7)(a)2.2. The caption, except that the word “certificate” may be used instead of “policy,” if appropriate: “The Wisconsin Insurance Commissioner has set minimum standards for Medicare cost insurance. This policy meets these standards. For an explanation of these standards and other important information, see ‘Wisconsin Guide to health Insurance for People with Medicare,’ given to you when you bought this policy. Do not buy this policy if you did not get this guide;” Ins 3.39(7)(a)3.3. Upon exhaustion of Medicare hospital inpatient psychiatric coverage, at least 175 days per lifetime for inpatient psychiatric hospital care; Ins 3.39(7)(a)4.4. Medicare Part A eligible expenses in a skilled nursing facility for the copayments for the 21st through the 100th day; Ins 3.39(7)(a)5.5. All Medicare Part A eligible expenses for blood to the extent not covered by Medicare; Ins 3.39(7)(a)6.6. All Medicare Part B eligible expenses to the extent not paid by Medicare, or in the case of hospital outpatient department services paid under a prospective payment system, the copayment amount, including outpatient psychiatric care, subject to Medicare Part B calendar year deductible; Ins 3.39(7)(a)7.7. Coverage for the first three pints of blood payable under Medicare Part B; Ins 3.39(7)(a)8.8. Coverage of Medicare Part A eligible expenses for hospitalization to the extent not covered by Medicare from the 61st day through the 90th day in any Medicare benefit period; Ins 3.39(7)(a)9.9. Coverage of Medicare Part A eligible expenses incurred as daily hospital charges during use of Medicare’s lifetime hospital inpatient reserve days; Ins 3.39(7)(a)10.10. Upon exhaustion of all Medicare hospital inpatient coverage including the lifetime reserve days, coverage of all Medicare Part A expenses for hospitalization not covered by Medicare and to the extent the hospital is permitted to charge by federal law and regulation or at the Medicare reimbursement rate; and