62A.28 COVERAGE FOR SCALP HAIR PROSTHESES.
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62A.28 COVERAGE FOR SCALP HAIR PROSTHESES.
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Subdivision 1. Scope of coverage.
This section applies to all policies of accident and health insurance, health maintenance contracts regulated under chapter 62D, health benefit certificates offered through a fraternal benefit society regulated under chapter 64B, and group subscriber contracts offered by nonprofit health service plan corporations regulated under chapter 62C. This section does not apply to policies designed primarily to provide coverage payable on a per diem, fixed indemnity or nonexpense incurred basis, or policies that provide only accident coverage.
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Subd. 2. Required coverage.
(a)Every policy, plan, certificate, or contract referred to in subdivision 1 must provide coverage for scalp hair prostheses, including all equipment and accessories necessary for regular use of scalp hair prostheses, worn for hair loss suffered as a result of a health condition, including but not limited to alopecia areata or the treatment for cancer, unless there is a clinical basis for limitation.
(b)The coverage required by this section is subject to the co-payment, coinsurance, deductible, and other enrollee cost-sharing requirements that apply to similar types of items under the policy, plan, certificate, or contract and may be limited to one prosthesis per benefit year.
(c)The coverage required by this section for scalp hair prostheses is limited to $1,000 per benefit year.
(d)A scalp hair prosthesis must be prescribed by a doctor to be covered under this section.