§ 27-41-33 - Coverage for infertility. - Rhode Island Statutes

SECTION 27-41-33

   § 27-41-33  Coverage for infertility.– (a) Any health maintenance organization service contract plan or policydelivered, issued for delivery, or renewed in this state, except a contractproviding 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 ahealth maintenance organization provides reimbursement for a test or procedureused in the diagnosis or treatment of conditions other than infertility, thosetests and procedures shall not be excluded from reimbursement when providedattendant to the diagnosis and treatment of infertility for women between theages of twenty-five (25) and forty-two (42) years; provided, that subscribercopayment, 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 healthy married individual who is unable to conceiveor 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).