609.655 Coverage of certain services provided to dependent students.
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609.655 Coverage of certain services provided to dependent students.
(1)In this section:
(a)“Dependent student” means an individual who satisfies all of the following:
1. Is covered as a dependent child under the terms of a policy or certificate issued by a defined network plan insurer.
2. Is enrolled in a school located in this state but outside the geographical service area of the defined network plan.
(b)“Outpatient services” has the meaning given in s. 632.89
(e).
(c)“School” means a technical college; an institution within the University of Wisconsin System; and any institution of higher education that grants a bachelor’s or higher degree.
(2)If a policy or certificate issued by a defined network plan insurer provides coverage of outpatient services provided to a dependent student, the policy or certificate shall provide coverage of outpatient services, to the extent and in the manner required under sub.
(3), that are provided to the dependent student while he or she is attending a school located in this state but outside the geographical service area of the defined network plan, notwithstanding the limitations regarding participating providers, primary providers, and referrals under ss. 609.01
(2)and 609.05
(3).
(3)Except as provided in sub.
(5), a defined network plan shall provide coverage for all of the following services:
(a)A clinical assessment of the dependent student’s nervous or mental disorders or alcoholism or other drug abuse problems, conducted by a provider described in s. 632.89
(e)2. , 3. , or 4. who is located in this state and in reasonably close proximity to the school in which the dependent student is enrolled and who may be designated by the defined network plan.