§ 27-18-30 - Health insurance contracts – Infertility. - Rhode Island Statutes

SECTION 27-18-30

   § 27-18-30  Health insurance contracts– Infertility. – (a) Any health insurance contract, plan, or policy delivered or issued fordelivery or renewed in this state, except contracts providing supplementalcoverage to Medicare or other governmental programs, which includes pregnancyrelated benefits, shall provide coverage for medically necessary expenses ofdiagnosis and treatment of infertility for women between the ages oftwenty-five (25) and forty-two (42) years. To the extent that a healthinsurance contract provides reimbursement for a test or procedure used in thediagnosis or treatment of conditions other than infertility, the tests andprocedures shall not be excluded from reimbursement when provided attendant tothe diagnosis and treatment of infertility for women between the ages oftwenty-five (25) and forty-two (42) years; provided, that a subscriberco-payment not to exceed twenty percent (20%) may be required for thoseprograms and/or procedures the sole purpose of which is the treatment ofinfertility.

   (b) For the purpose of this section, "infertility" means thecondition of an otherwise presumably healthy married individual who is unableto conceive or sustain a pregnancy during a period of one year.

   (c) Notwithstanding the provisions of § 27-18-19 or anyother provision to the contrary, this section shall apply to blanket or grouppolicies of insurance.

   (d) The health insurance contract may limit coverage to alifetime cap of one hundred thousand dollars ($100,000).