(a) This section applies to each policy or contract that is issued or delivered in the State to an employer or individual by an insurer or nonprofit health service plan.
(b) (1) A policy or contract subject to this section that provides coverage on a group or individual basis for a diagnostic or surgical procedure involving a bone or joint of the skeletal structure may not exclude or deny coverage for the same diagnostic or surgical procedure involving a bone or joint of the face, neck, or head if, under the accepted standards of the profession of the health care provider rendering the service, the procedure is medically necessary to treat a condition caused by a congenital deformity, disease, or injury.
(2) This subsection does not apply to intraoral prosthetic devices.
(c) (1) This section does not affect any other coverage required under this article or restrict the scope of coverage under a policy or contract subject to this section.
(2) This section is not intended to encourage surgical procedures over appropriate nonsurgical procedures, or to prohibit the continued coverage of nonsurgical procedures in the treatment of a bone or joint of the face, neck, or head.
Structure Maryland Statutes
Subtitle 8 - Required Health Insurance Benefits
Section 15-801 - Benefits for Alzheimer's Disease and Care of Elderly Individuals
Section 15-803 - Payments for Blood Products
Section 15-804 - Coverage for Off-Label Use of Drugs
Section 15-805 - Reimbursement for Pharmaceutical Products
Section 15-806 - Choice of Pharmacy for Filling Prescriptions
Section 15-807 - Coverage for Medical Foods and Modified Food Products
Section 15-808 - Benefits for Home Health Care
Section 15-809 - Benefits for Hospice Care Services
Section 15-810 - Benefits for in Vitro Fertilization
Section 15-810.1 - Coverage for Standard Fertility Preservation Procedures
Section 15-811 - Hospitalization Benefits for Childbirth
Section 15-812 - Inpatient Hospitalization Coverage for Mothers and Newborn Children
Section 15-813 - Benefits for Disability Caused by Pregnancy or Childbirth
Section 15-814 - Coverage for Breast Cancer Screenings
Section 15-815 - Coverage for Reconstructive Breast Surgery
Section 15-816 - Benefits for Routine Gynecological Care
Section 15-817 - Coverage for Child Wellness Services
Section 15-818 - Benefits for Treatment of Cleft Lip and Cleft Palate
Section 15-819 - Coverage for Outpatient Services and Second Opinions
Section 15-820 - Benefits for Orthopedic Braces
Section 15-821 - Diagnostic and Surgical Procedures for Bones of Face, Neck, and Head
Section 15-822 - Coverage for Diabetes Equipment, Supplies, and Self-Management Training
Section 15-823 - Coverage for Osteoporosis Prevention and Treatment
Section 15-824 - Coverage for Maintenance Drugs
Section 15-825 - Coverage for Detection of Prostate Cancer
Section 15-826 - Coverage for Prescription Drugs
Section 15-826.1 - Coverage for Contraceptive Drugs and Devices
Section 15-826.2 - Coverage for Male Sterilization
Section 15-826.3 - Coverage for Fertility Awareness-Based Methods
Section 15-827 - Coverage for Patient Cost for Clinical Trials
Section 15-828 - Coverage for Charges Related to Dental Care
Section 15-829 - Coverage for Detection of Chlamydia
Section 15-830 - Referrals to Specialists
Section 15-831 - Coverage of Prescription Drugs
Section 15-832 - Coverage for Removal of Testicle
Section 15-832.1 - Inpatient Hospitalization Coverage Following Mastectomy
Section 15-833 - Extension of Benefits
Section 15-834 - Coverage for Prostheses
Section 15-835 - Required Coverage for Habilitative Services
Section 15-836 - Hair Prosthesis
Section 15-837 - Colorectal Cancer Screening Coverage
Section 15-838 - Hearing Aid Coverage for a Minor Child
Section 15-839 - Coverage for Treatment of Morbid Obesity
Section 15-840 - Coverage for Medically Necessary Residential Crisis Services
Section 15-841 - Coverage for Smoking Cessation Treatment
Section 15-842 - Copayment or Coinsurance for Prescription Drugs and Devices Limited
Section 15-843 - Coverage for Amino Acid-Based Elemental Formula
Section 15-844 - Benefits for Prosthetic Devices
Section 15-845 - Coverage for Refills of Prescription Eye Drops
Section 15-846 - Coverage for Cancer Chemotherapy
Section 15-847 - Coverage for Specialty Drugs
Section 15-847.1 - Copayment or Coinsurance Limits for Certain Drugs -- Annual Increase Regulated
Section 15-848 - Coverage for Ostomy Equipment and Supplies
Section 15-849 - Coverage for Abuse-Deterrent Opioid Analgesic Drug Products
Section 15-850 - Prior Authorizations for Opioid Antagonist
Section 15-851 - Prior Authorization for Drug Products to Treat Opioid Use Disorder -- Prohibition
Section 15-853 - Coverage for Lymphedema Diagnosis, Evaluation, and Treatment
Section 15-854 - Prior Authorization for Prescription Drug
Section 15-855 - Coverage for Pediatric Autoimmune Neuropsychiatric Disorders