§ 27-18-30. Health insurance contracts — Infertility.
(a) Any health insurance contract, plan, or policy delivered or issued for delivery or
renewed in this state, except contracts providing supplemental coverage to Medicare
or other governmental programs, that includes pregnancy-related benefits, shall provide
coverage for medically necessary expenses of diagnosis and treatment of infertility
for women between the ages of twenty-five (25) and forty-two (42) years and for standard
fertility-preservation services when a medically necessary medical treatment may directly
or indirectly cause iatrogenic infertility to a covered person. To the extent that
a health insurance contract provides reimbursement for a test or procedure used in
the diagnosis or treatment of conditions other than infertility, the 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 a 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 purposes of this section, "infertility� means the condition of an otherwise presumably
healthy individual who is unable to conceive or sustain a pregnancy during a period
of one year.
(c) For purposes of this section, "standard fertility-preservation services� means procedures
consistent with established medical practices and professional guidelines published
by the American Society for Reproductive Medicine, the American Society of Clinical
Oncology, or other reputable professional medical organizations.
(d) For purposes of this section, "iatrogenic infertility� means an impairment of fertility
by surgery, radiation, chemotherapy, or other medical treatment affecting reproductive
organs or processes.
(e) For purposes of this section, "may directly or indirectly cause� means treatment with
a likely side effect of infertility as established by the American Society for Reproductive
Medicine, the American Society of Clinical Oncology, or other reputable professional
organizations.
(f) Notwithstanding the provisions of § 27-18-19 or any other provision to the contrary, this section shall apply to blanket or group
policies of insurance.
(g) The health insurance contract may limit coverage to a lifetime cap of one hundred
thousand dollars ($100,000).