§ 56-7-2507 — Reconstructive breast surgery

(a) (1) Any individual, franchise, blanket or group health insurance policy, medical service plan, contract, hospital service corporation contract, hospital and medical service corporation contract, fraternal benefit society, health maintenance organization, or managed care organization that provides coverage for mastectomy surgery shall provide coverage for all stages of reconstructive breast surgery on the diseased breast as a result of a mastectomy, but not including a lumpectomy, as well as any surgical procedure on the nondiseased breast deemed necessary to establish symmetry between the two (2) breasts in the manner chosen by the patient and physician. The surgical procedure performed on a nondiseased breast to establish symmetry with the diseased breast must occur within five (5) years of the date the reconstructive breast surgery was performed on a diseased breast. (2) Coverage for reconstructive breast surgery shall be subject to applicable copayments, coinsurance and deductibles. (b) This section applies to any policy, plan, or contract entered into or renewed on or after July 1, 1997.

Legislative History

Acts 1997, ch. 452, § 1.