§ 36-6060.9. Coverage for wigs or other scalp prostheses.  


Latest version.
  • A.  Any health benefit plan, including the State and Education Employees Group Health Insurance Plan, that is offered, issued, or renewed in this state on or after January 1, 2001, that provides medical and surgical benefits with respect to the treatment of cancer and other conditions treated by chemotherapy or radiation therapy shall provide coverage for wigs or other scalp prostheses necessary for the comfort and dignity of the covered person.

    B.  The coverage provided for by this section shall be subject to the same annual deductibles, copayments, or coinsurance limits as established for all other covered benefits under the health benefit plan not to exceed One Hundred Fifty Dollars ($150.00) annually.

    C.  A health benefit plan shall provide notice to each insured or enrollee under the plan regarding the coverage required by this section in the evidence of coverage of the plan and shall provide additional written notice of the coverage to the insured or enrollee as follows:

    1.  In the next mailing made by the plan to the insured or enrolled employee;

    2.  As part of any yearly informational packet sent to the enrollee; or

    3.  Not later than December 1, 2000;

    whichever is earlier.

    D.  As used in this act, "health benefit plan" means any plan or arrangement as defined in subsection C of Section 6060.4 of this title.  However, this section shall not apply to policies or certificates issued to individuals or groups with fifty (50) or fewer employees or plans offered under the State Medicaid Program.

    E.  The Insurance Commissioner shall promulgate any rules necessary to implement the provisions of this section.

Added by Laws 2000, c. 171, § 4, eff. July 1, 2000.  Amended by Laws 2010, c. 222, § 40, eff. Nov. 1, 2010.