31A-22-630 - Mastectomy coverage.
31A-22-630. Mastectomy coverage.
(1) If an insured has coverage that provides medical and surgical benefits with respect toa mastectomy, it shall provide coverage, with consultation of the attending physician and thepatient, 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 performedto produce symmetrical appearance; and
(c) prostheses and physical complications with regards to all stages of mastectomy,including lymphedemas.
(2) (a) This section does not prevent an accident and health insurer from imposingcost-sharing measures for health benefits relating to this coverage, if cost-sharing measures arenot greater than those imposed on any other medical condition.
(b) For purposes of this Subsection (2), cost-sharing measures include imposing adeductible or coinsurance requirement.
(3) Written notice of the availability of the coverage described in Subsection (1) shall bedelivered to the participant:
(a) upon enrollment; and
(b) annually after the enrollment.
Amended by Chapter 116, 2001 General Session