(a) Every individual health insurance policy, contract or certificate that is delivered or issued for delivery in this State by any health insurer, health service corporation or managed care organization which provide for medical or hospital expenses and also provide coverage for other prostheses, shall provide coverage for expenses for a scalp hair prosthesis worn for hair loss suffered as a result of alopecia areata, resulting from an autoimmune disease. Such coverage shall be subject to the same limitations and guidelines as other prostheses, provided that such coverage for alopecia areata shall not exceed $500 per year.
(b) For purposes of this section:
(1) “Prostheses” means artificial appliances used to replace lost natural structures. Prostheses include, but are not limited to, artificial arms, legs, breasts, or glass eyes.
(2) “Scalp hair prosthesis” means an artificial substitute for scalp hair that is made specifically for a specific individual.
(c) Such coverage may be subject to annual deductibles and co-insurance provisions as may be deemed appropriate and as are consistent with those established for other benefits under the plan of coverage. Written notice of the availability of such coverage shall be delivered to the insured, participant, policyholder, subscriber and beneficiary upon enrollment and annually thereafter.
(d) All group and blanket health benefit plans shall provide notice to each insured, participant, policyholder, subscriber and beneficiary under such plan regarding the coverage required by this section in accordance herewith. Such notice shall be in writing and prominently positioned in any literature or correspondence made available or distributed by the plan and shall be transmitted as part of any yearly informational packet sent to the insured, participant, policyholder, subscriber and beneficiary.
Structure Delaware Code
Chapter 33. HEALTH INSURANCE CONTRACTS
Subchapter I. General Provisions
§ 3303. Scope, format of policy [For application of this section, see 79 Del. Laws, c. 99, § 19].
§ 3304. Required provisions; captions; omissions; substitutions.
§ 3305. Entire contract; changes.
§ 3306. Time limit on certain defenses.
§ 3312. Time of payment of claims.
§ 3314. Physical examination; autopsy.
§ 3316. Change of beneficiary.
§ 3317. Optional policy provisions.
§ 3320. Overinsurance; all coverages.
§ 3321. Relation of earnings to insurance.
§ 3323. Conformity with state statutes.
§ 3325. Intoxicants and narcotics.
§ 3327. Order of certain provisions.
§ 3328. Third-party ownership.
§ 3329. Requirements of other jurisdictions.
§ 3330. Policies issued for delivery in another state.
§ 3331. Conforming to statute.
§ 3334. Franchise health insurance law.
§ 3336. Midwife services reimbursement.
§ 3338. Coverage of cancer monitoring test.
§ 3338A. Equal reimbursement for oral and intravenous anticancer medication.
§ 3340. Child abuse or neglect — Individual coverage.
§ 3341. Newborns and mothers health protection.
§ 3342. Obstetrical and gynecological coverage.
§ 3342A. Contraceptive coverage.
§ 3344. Insurance coverage for diabetes.
§ 3344B. Cost sharing in prescription insulin drugs.
§ 3344C. Coverage for insulin pumps.
§ 3345. Annual pap smear coverage reimbursement.
§ 3346. Colorectal cancer screening.
§ 3347. Required coverage for reconstructive surgery following mastectomies.
§ 3349A. Required coverage for volunteer ambulance company services.
§ 3350. Prescription medication.
§ 3351B. Experimental treatment coverage.
§ 3352. Newborn and infant hearing screening; coverage and reimbursement.
§ 3353. Use of social security numbers on insurance cards.
§ 3355. Phenylketonuria (PKU) and other inherited metabolic diseases.
§ 3356. Required coverage for scalp hair prosthesis.
§ 3358. Dental services for children with a severe disability.
§ 3359. Health insurance; pharmacies; electronic reimbursement.
§ 3359B. Electronic medical (non-pharmaceutical) claims.
§ 3360. Screening of infants and toddlers for developmental delays.
§ 3362. Reimbursement for orthotic and prosthetic services.
§ 3363. Recommended immunizations.
§ 3364. Specialty tier prescription coverage.
§ 3365. School-based health centers.
§ 3366. Autism spectrum disorders coverage.
§ 3367. Payment for emergency medical services.
§ 3370. Telehealth and telemedicine.
§ 3370A. Network disclosure and transparency.
§ 3370C. Time of submitting claim for reimbursement.
§ 3370D. Coverage for epinephrine autoinjectors.
§ 3370E. Annual behavioral health well check [Effective Jan. 1, 2024].