2011 California Code
Health and Safety Code
DIVISION 106. PERSONAL HEALTH CARE (INCLUDING MATERNAL, CHILD, AND ADOLESCENT) [123100 - 125850]
CHAPTER 3. Catastrophic Health Insurance
Section 123180
As used in this chapter:
(a) Catastrophic health insurance means a supplementary insurance contract that indemnifies a California resident for medical expenses, including at least the costs of the basic health care services that result from an illness, injury, or disease, and that are greater than fifty thousand dollars ($50,000), subject to a lifetime benefit limit of one million dollars ($1,000,000).
(b) Resident means any individual who lives in California for at least 90 consecutive days.
(c) Insurer as used in this chapter includes a disability insurer that covers hospital, medical, or surgical expenses, and a nonprofit hospital service plan.
(d) Basic health care services includes, but is not limited to, the following:
(1) Inpatient hospital treatment, including room and board, general nursing services, diagnostic tests, supplies, and other medically necessary services.
(2) Outpatient services for surgery, presurgical diagnostic tests, emergency care, and chemotherapy.
(3) Surgery and anesthesia.
(4) Hospital and office visits and consultations.
(5) X-rays and laboratory tests; allergy tests, injections, and sera.
(6) Maternity care for the subscriber or enrolled spouse.
(7) Psychotherapy.
(8) Chemotherapy and radiation therapy.
(9) Physical, speech, occupational and respiratory therapies.
(10) Prescription drugs.
(11) Prostheses and durable medical equipment, such as artificial limbs, hospital beds, and wheelchairs.
(12) Cardiac rehabilitation program.
(13) Local ambulance service.
(14) Alcohol and drug abuse rehabilitation.
(15) Rehabilitative care.
(16) Outpatient skilled nursing care (up to two hours per day for up to 50 days per calendar year).
(17) Home health care and hospice services provided by an approved home health agency or hospice agency.
(Added by Stats. 1995, Ch. 415, Sec. 8. Effective January 1, 1996.)
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