CHAPTER 1354. ELIGIBILITY FOR BENEFITS FOR ALZHEIMER'S DISEASE - Texas Statutes

INSURANCE CODE

TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES

SUBTITLE E. BENEFITS PAYABLE UNDER HEALTH COVERAGES

CHAPTER 1354. ELIGIBILITY FOR BENEFITS FOR ALZHEIMER'S DISEASE

Sec. 1354.001. APPLICABILITY OF CHAPTER. This chapter applies

only to a health benefit plan that:

(1) provides coverage for Alzheimer's disease; and

(2) is an individual or group policy, contract, certificate, or

evidence of coverage that is delivered or issued for delivery in

this state by an insurer or a group hospital service corporation

operating under Chapter 842.

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1,

2005.

Sec. 1354.002. PROOF OF ORGANIC DISEASE. If a health benefit

plan requires demonstrable proof of organic disease or other

proof before the health benefit plan issuer will authorize

payment of benefits for Alzheimer's disease, that proof

requirement is satisfied by a clinical diagnosis of Alzheimer's

disease made by a physician licensed in this state, including a

history and physical, neurological, and psychological or

psychiatric evaluations, and laboratory studies.

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1,

2005.