§ 27-19-23 - Coverage for infertility. - Rhode Island Statutes

SECTION 27-19-23

   § 27-19-23  Coverage for infertility.– (a) Any nonprofit hospital service contract, plan, or insurance policiesdelivered, issued for delivery, or renewed in this state, except contractsproviding supplemental coverage to Medicare or other governmental programs,which includes pregnancy related benefits shall provide coverage for medicallynecessary expenses of diagnosis and treatment of infertility for women betweenthe ages of twenty-five (25) and forty-two (42) years. To the extent that anonprofit hospital service corporation provides reimbursement for a test orprocedure used in the diagnosis or treatment of conditions other thaninfertility, those tests and procedures shall not be excluded fromreimbursement when provided attendant to the diagnosis and treatment ofinfertility for women between the ages of twenty-five (25) and forty-two (42)years; provided, that a subscriber copayment, not to exceed twenty percent(20%), may be required for those programs and/or procedures the sole purpose ofwhich is the treatment of infertility.

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