(a) All group and blanket health insurance policies, contracts or certificates that are 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 artificial substitutes for scalp hair that are 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 35. GROUP AND BLANKET HEALTH INSURANCE
Subchapter III. Provisions Applicable to Group and Blanket Health Insurance
§ 3552. Cancer screening tests.
§ 3553. Midwife services reimbursement.
§ 3555. Coverage of cancer monitoring tests.
§ 3555A. Equal reimbursement for oral and intravenous anticancer medication.
§ 3556. Obstetrical and gynecological coverage.
§ 3557. Child abuse or neglect — Group coverage.
§ 3558. Immunizations and preventive services.
§ 3559. Contraceptive coverage.
§ 3560. Insurance coverage for diabetes.
§ 3560A. Cost sharing in prescription insulin drugs.
§ 3560B. Coverage for insulin pumps.
§ 3561. Annual pap smear coverage reimbursement.
§ 3562. Colorectal cancer screening.
§ 3563. Required coverage for reconstructive surgery following mastectomy.
§ 3565A. Required coverage for volunteer ambulance company services.
§ 3566. Prescription medication.
§ 3567B. Experimental treatment coverage.
§ 3568. Newborn and infant hearing screening; coverage and reimbursement.
§ 3569. Use of Social Security numbers on insurance cards.
§ 3570A. Autism spectrum disorders coverage.
§ 3571. Phenylketonuria (PKU) and other inherited metabolic diseases.
§ 3571A. Hearing aid coverage.
§ 3571B. Required coverage for scalp hair prosthesis.
§ 3571C. Dental services for children with a severe disability.
§ 3571D. Screening of infants and toddlers for developmental delays.
§ 3571E. Reimbursement for orthotic and prosthetic services.
§ 3571G. School-based health centers.
§ 3571H. Payment for emergency medical services.
§ 3571P. Rating factors [For application of this section, see 79 Del. Laws, c. 99, § 19].
§ 3571R. Telehealth and telemedicine.
§ 3571S. Network disclosure and transparency.
§ 3571U. Mental Health Parity and Addiction Equity Act reporting requirements.
§ 3571V. Time of submitting claim for reimbursement.
§ 3571W. Electronic medical claims.
§ 3571X. Medication assisted treatment for drug and alcohol dependencies.
§ 3571Y. Coverage for epinephrine autoinjectors.
§ 3571Z. Annual behavioral health well check [Effective Jan. 1, 2024].