(1) If an insured has coverage that provides medical and surgical benefits with respect to a mastectomy, it shall provide coverage, with consultation of the attending physician and the patient, for: (a) reconstruction of the breast on which the mastectomy has been performed; (b) surgery and reconstruction of the breast on which the mastectomy was not performed to produce symmetrical appearance; and (c) prostheses and physical complications with regards to all stages of mastectomy, including lymphedemas.
(a) reconstruction of the breast on which the mastectomy has been performed;
(b) surgery and reconstruction of the breast on which the mastectomy was not performed to produce symmetrical appearance; and
(c) prostheses and physical complications with regards to all stages of mastectomy, including lymphedemas.
(2) (a) This section does not prevent an accident and health insurer from imposing cost-sharing measures for health benefits relating to this coverage, if cost-sharing measures are not greater than those imposed on any other medical condition. (b) For purposes of this Subsection (2), cost-sharing measures include imposing a deductible or coinsurance requirement.
(a) This section does not prevent an accident and health insurer from imposing cost-sharing measures for health benefits relating to this coverage, if cost-sharing measures are not greater than those imposed on any other medical condition.
(b) For purposes of this Subsection (2), cost-sharing measures include imposing a deductible or coinsurance requirement.
(3) Written notice of the availability of the coverage described in Subsection (1) shall be delivered to the participant: (a) upon enrollment; and (b) annually after the enrollment.
(a) upon enrollment; and
(b) annually after the enrollment.
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