TITLE 27
Insurance
CHAPTER 27-20
Nonprofit Medical Service Corporations
SECTION 27-20-20
§ 27-20-20 Coverage for infertility.
(a) Any nonprofit medical service contract, plan, or insurance policies
delivered, issued for delivery, or renewed in this state, except contracts
providing supplemental coverage to Medicare or other governmental programs,
which includes pregnancy related benefits shall provide coverage for the
medically necessary expenses of diagnosis and treatment of infertility for
women between the ages of twenty-five (25) and forty-two (42) years. To the
extent that a nonprofit medical service corporation provides reimbursement for
a test or procedure used in the diagnosis or treatment of conditions other than
infertility, those tests and procedures shall not be excluded from
reimbursement when provided attendant to the diagnosis and treatment of
infertility for women between the ages of twenty-five (25) and forty-two (42)
years. Provided, that subscriber copayment, not to exceed twenty percent (20%),
may be required for those programs and/or procedures the sole purpose of which
is the treatment of infertility.
(b) For the purposes of this section, "infertility" means the
condition of an otherwise presumably healthy married individual who is unable
to conceive or sustain a pregnancy during a period of one year.
(c) The health insurance contract may limit coverage to a
lifetime cap of one hundred thousand dollars ($100,000).
History of Section.
(P.L. 1989, ch. 478, § 3; P.L. 2002, ch. 292, § 39; P.L. 2006, ch.
246, art. 34, § 3; P.L. 2007, ch. 411, § 3.)
