31A-22-630. Mastectomy coverage.

169 words·~1 min read·/ut/title-31a/chapter-22/31a-22-630

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

(1)If an insured has coverage that provides medical and surgical benefits with respect to a mastectomy, it shall provide coverage, with consultation of the attending physician and the patient, for:

(a)reconstruction of the breast on which the mastectomy has been performed;

(b)surgery and reconstruction of the breast on which the mastectomy was not performed to produce symmetrical appearance; and

(c)prostheses and physical complications with regards to all stages of mastectomy, including lymphedemas.

(a)This section does not prevent an accident and health insurer from imposing cost-sharing measures for health benefits relating to this coverage, if cost-sharing measures are not greater than those imposed on any other medical condition.

(b)For purposes of this Subsection

(2), cost-sharing measures include imposing a deductible or coinsurance requirement.

(3)Written notice of the availability of the coverage described in Subsection

(1)shall be delivered to the participant:

(a)upon enrollment; and

(b)annually after the enrollment.

Amended by Chapter 116 , 2001 General Session