§ 535. Services related to termination of pregnancy.
201 words·~1 min read·
/de/title-31/chapter-5-state-public-assistance-code/535A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
(a)Carriers shall cover services related to the termination of pregnancy up to a maximum of $750 per covered individual per year in all health benefit plans delivered or issued for delivery under § 505(3) of this title.
(b)Coverage provided under this section may not be subject to any deductible, coinsurance, copayment, or any other cost-sharing requirement up to the $750 maximum.
(c)A carrier must provide coverage for the full scope of services permissible under the law.
(d)Coverage provided under this section may not require a referral or prior authorization as a condition of coverage.
(e)If a policy or contract limits an insured’s access to a network of participating providers for other health-care services, then it may limit access for services related to termination of pregnancy, but the policy or contract must include in all its provider networks a sufficient number of providers of termination of pregnancy services to accommodate the direct access needs of their enrollees.
(f)Coverage provided under this section must be funded by Delaware state resources if services are not eligible for federal funds. If federal funds are permitted to be used for services under this section, then federal funds must be used.