US Laws, Codes, Statutes & Cases

                                  TITLE  41
                                  INSURANCE
                                  CHAPTER 39
                             MANAGED CARE REFORM
    41-3926.  MAMMOGRAPHY COVERAGE. (1) From and after July 1, 1992, all
policies, contracts, plans or certificates issued by an organization offering
a managed care plan which provide coverage for the surgical procedure known as
a mastectomy which are delivered, issued for delivery, continued or renewed in
this state shall provide minimum mammography examination or equivalent
examination coverage. Such coverage shall include at least the following
benefits:
    (a)  One (1) baseline mammogram for any woman who is thirty-five (35)
    through thirty-nine (39) years of age.
    (b)  A mammogram every two (2) years for any woman who is forty (40)
    through forty-nine (49) years of age, or more frequently if recommended
    by the woman's physician.
    (c)  A mammogram every year for any woman who is fifty (50) years of age
    or older.
    (d)  A mammogram for any woman desiring a mammogram for medical cause.
Such coverage shall not exceed the cost of the examination.
    (2)  As used in this section, "mastectomy" means the removal of all or
part of the breast for medically necessary reasons as determined by a licensed
physician.
    (3)  Nothing in this section shall apply to specified accident, specified
disease, hospital indemnity, medicare supplement, long-term care or other
limited benefit health insurance policies.