§ 27-41-33. Coverage for infertility.
(a) Any health maintenance organization service contract plan or policy delivered, issued
for delivery, or renewed in this state, except a contract 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.
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§ 27-41-33. Coverage for infertility.
(a) Any health maintenance organization service contract plan or policy delivered, issued
for delivery, or renewed in this state, except a contract 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 maintenance organization 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 purposes of this section, "infertility� means the condition of an otherwise 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) The health insurance contract may limit coverage to a lifetime cap of one hundred
thousand dollars ($100,000).