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Current as of January 01, 2024 | Updated by Findlaw Staff
(a) A health benefit plan that provides coverage for mastectomy must provide coverage for:
(1) reconstruction of the breast on which the mastectomy has been performed;
(2) surgery and reconstruction of the other breast to achieve a symmetrical appearance; and
(3) prostheses and treatment of physical complications, including lymphedemas, at all stages of mastectomy.
(b) Coverage required under this section:
(1) shall be provided in a manner determined to be appropriate in consultation with the attending physician and the enrollee;
(2) may be subject to annual deductibles, copayments, and coinsurance that are consistent with annual deductibles, copayments, and coinsurance required for other coverage under the health benefit plan; and
(3) may not be subject to dollar limits other than the lifetime maximum benefits under the plan.
Cite this article: FindLaw.com - Texas Insurance Code - INS § 1357.004. Coverage Required - last updated January 01, 2024 | https://codes.findlaw.com/tx/insurance-code/ins-sect-1357-004/
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature before relying on it for your legal needs.
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