Sec. 10. Catastrophic plan
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Subpart 1 of part B of title XXVII of the Public Health Service Act ( 42 U.S.C. 300gg–41 et seq. ) is amended by adding at the end the following: Each health insurance issuer that offers health insurance coverage in the individual market in a State shall offer a catastrophic plan in such State in such market. To meet the requirements of this section, a catastrophic plan must provide for the essential health benefits, as defined by the Secretary under subsection (c). The Secretary shall define the essential health benefits, except that such benefits shall include— coverage for at least three primary care visits during a plan year; and at least the following general categories and the items and services covered within the categories:
Ambulatory patient services. Emergency services. Hospitalization. Maternity and newborn care. Mental health and substance use disorder services, including behavioral health treatment. Prescription drugs. Rehabilitative and habilitative services and devices. Laboratory services. Preventive and wellness services and chronic disease management. Pediatric services, including oral and vision care. If a health insurance issuer offers a health plan described in this section, the issuer may only offer the plan in the individual market. .
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- 42 USC 300gg–41
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Sec. 10
Catastrophic plan
Cite42 USC 300gg–41
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