41-3926. MAMMOGRAPHY COVERAGE. (1) From and after July 1, 1992, all policies, contracts, plans or certificates issued by an organization offering a managed care plan which provide coverage for the surgical procedure known as a mastectomy which are delivered, issued for delivery, continued or renewed in this state shall provide minimum mammography examination or equivalent examination coverage. Such coverage shall include at least the following benefits:
(a) One (1) baseline mammogram for any woman who is thirty-five (35) through thirty-nine (39) years of age.
(b) A mammogram every two (2) years for any woman who is forty (40) through forty-nine (49) years of age, or more frequently if recommended by the woman’s physician.
(c) A mammogram every year for any woman who is fifty (50) years of age or older.
(d) A mammogram for any woman desiring a mammogram for medical cause.
Such coverage shall not exceed the cost of the examination.
(2) As used in this section, "mastectomy" means the removal of all or part of the breast for medically necessary reasons as determined by a licensed physician.
(3) Nothing in this section shall apply to specified accident, specified disease, hospital indemnity, medicare supplement, long-term care or other limited benefit health insurance policies.
History:
[(41-3926), added 1992, ch. 132, sec. 4, p. 415; am. 1993, ch. 113, sec. 4, p. 290; am. and redesig. 1997, ch. 204, sec. 29, p. 599.]
Structure Idaho Code
Chapter 39 - MANAGED CARE REFORM
Section 41-3901 - SHORT TITLE.
Section 41-3902 - INTENT AND PURPOSE.
Section 41-3903 - DEFINITIONS.
Section 41-3905 - QUALIFICATIONS FOR CERTIFICATE OF AUTHORITY.
Section 41-3906 - APPLICATION FOR CERTIFICATE OF AUTHORITY.
Section 41-3910 - REPORTS TO THE DIRECTOR.
Section 41-3911 - EXAMINATIONS.
Section 41-3912 - SUSPENSION OR REVOCATION OF CERTIFICATE OF AUTHORITY.
Section 41-3914 - ANNUAL DISCLOSURES.
Section 41-3915 - HEALTH CARE CONTRACTS.
Section 41-3916 - ADVISORY PANELS.
Section 41-3917 - CERTAIN WORDS PROHIBITED IN NAME OF ORGANIZATION.
Section 41-3918 - GRIEVANCE SYSTEM.
Section 41-3919 - OPEN ENROLLMENT.
Section 41-3921 - STATUTORY CONSTRUCTION AND RELATIONSHIP TO OTHER LAWS.
Section 41-3922 - TAXATION — PENALTY FOR FAILURE TO FILE.
Section 41-3924 - LIMITATION OF BENEFITS FOR ELECTIVE ABORTIONS.
Section 41-3925 - SERVICES PROVIDED BY GOVERNMENTAL ENTITIES.
Section 41-3926 - MAMMOGRAPHY COVERAGE.
Section 41-3928 - INCENTIVES TO WITHHOLD CARE PROHIBITED.
Section 41-3930 - UTILIZATION MANAGEMENT PROGRAM REQUIREMENTS.
Section 41-3931 - PARTICIPATION IN IDAHO LIFE AND HEALTH INSURANCE GUARANTY ASSOCIATION.