Maryland Insurance Section 15-815

Article - Insurance

§ 15-815.

      (a)      (1)      In this section the following words have the meanings indicated.

            (2)      "Mastectomy" means the surgical removal of all or part of a breast as a result of breast cancer.

            (3)      (i)      "Reconstructive breast surgery" means surgery performed as a result of a mastectomy to reestablish symmetry between the two breasts.

                  (ii)      "Reconstructive breast surgery" includes augmentation mammoplasty, reduction mammoplasty, and mastopexy.

      (b)      This section applies to:

            (1)      insurers and nonprofit health service plans that provide hospital, medical, or surgical benefits to individuals or groups on an expense-incurred basis under health insurance policies that are issued or delivered in the State; and

            (2)      health maintenance organizations that provide hospital, medical, or surgical benefits to individuals or groups under contracts that are issued or delivered in the State.

      (c)      An entity subject to this section shall provide coverage for reconstructive breast surgery, including coverage for all stages of reconstructive breast surgery performed on a nondiseased breast to establish symmetry with the diseased breast when reconstructive breast surgery is performed on the diseased breast.



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