§4089g. Craniofacial disorders

Link to law: http://legislature.vermont.gov/statutes/section/08/107/04089g
Published: 2015

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Banking and Insurance








4089g. Craniofacial disorders

(a) A health

insurance plan shall provide coverage for diagnosis and medically necessary

treatment, including surgical and nonsurgical procedures, for a musculoskeletal

disorder that affects any bone or joint in the face, neck or head and is the

result of accident, trauma, congenital defect, developmental defect, or

pathology. Subject to subsection (b) of this section, this coverage shall be

the same as that provided under the health insurance plan for any other

musculoskeletal disorder in the body and may be provided when prescribed or

administered by a physician or a dentist. This section shall not be construed

to require coverage for dental services for the diagnosis or treatment of

dental disorders or dental pathology primarily affecting the gums, teeth, or

alveolar ridge.

(b) A health

insurance plan may require a referral from a health care provider under

contract with the plan.

(c) As used in

this section, "health insurance plan" means any health insurance

policy or health benefit plan offered by a health insurer as defined in 18

V.S.A. § 9402. Health insurance plan includes any health benefit plan offered

or administered by the state, or any subdivision or instrumentality of the

state. (Added 1997, No. 95 (Adj. Sess.), § 1.)