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The Vermont Statutes Online
Title
08
:
Banking and Insurance
Chapter
107
:
HEALTH INSURANCE
Subchapter
001
:
GENERALLY
§
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.)