NRS 689A.0465 Policy prohibited from excluding coverage of treatment of temporomandibular joint; exception.

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A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

1. Except as otherwise provided in this section, no policy of health insurance may be delivered or issued for delivery in this state if it contains an exclusion of coverage of treatment of the temporomandibular joint whether by specific language in the policy or by a claims settlement practice. A policy may exclude coverage of those methods of treatment which are recognized as dental procedures, including, but not limited to, the extraction of teeth and the application of orthodontic devices and splints.

2. The insurer may limit its liability on the treatment of the temporomandibular joint to:

(a)No more than 50 percent of the usual and customary charges for such treatment actually received by an insured, but in no case more than 50 percent of the maximum benefits provided by the policy for such treatment; and

(b)Treatment which is medically necessary.

3. Any provision of a policy subject to the provisions of this chapter and issued or delivered on or after January 1, 1990, which is in conflict with this section is void.

REIMBURSEMENT FOR CERTAIN MEDICALLY RELATED TREATMENT AND SERVICES