41-4025. MAMMOGRAPHY COVERAGE. (1) From and after July 1, 1992, all self-funded plans 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:
[41-4025, added 1992, ch. 132, sec. 5, p. 415; am. 1993, ch. 113, sec. 5, p. 290.]
Structure Idaho Code
Chapter 40 - SELF-FUNDED HEALTH CARE PLANS
Section 41-4001 - DECLARATION OF PURPOSE.
Section 41-4002 - DEFINITIONS.
Section 41-4003 - REGISTRATION REQUIRED — EXEMPTIONS — NOT SUBJECT TO INSURANCE CODE.
Section 41-4004 - PLAN REQUIREMENTS.
Section 41-4005 - APPLICATION FOR REGISTRATION — FEE.
Section 41-4006 - GRANT OR DENIAL OF REGISTRATION.
Section 41-4007 - TRUST FUND — AUTHORITY.
Section 41-4008 - TRUST FUND LIABILITY — FIDUCIARY FUNDS.
Section 41-4009 - INVESTMENT OF TRUST FUND.
Section 41-4010 - RESERVES AND SURPLUS.
Section 41-4011 - RECORDS AND ACCOUNTS — ANNUAL STATEMENT.
Section 41-4013 - EXAMINATION OF BOOKS, RECORDS AND ACCOUNTS.
Section 41-4014 - TRUSTEES — ADMINISTRATORS — BONDING.
Section 41-4015 - PROHIBITED PECUNIARY INTERESTS IN PLAN MANAGEMENT.
Section 41-4016 - POLITICAL CONTRIBUTIONS PROHIBITED.
Section 41-4017 - RECOVERY OF DEPLETED FUNDS.
Section 41-4018 - TERMINATION OF REGISTRATION.
Section 41-4019 - LIQUIDATION OF TRUST FUND.
Section 41-4021 - OTHER PROVISIONS APPLICABLE.
Section 41-4023 - COVERAGE FROM MOMENT OF BIRTH — COMPLICATIONS OF PREGNANCY.
Section 41-4024 - SERVICES PROVIDED BY GOVERNMENTAL ENTITIES.