Required Health Insurance Benefits | Midpage

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Maryland Code

8

Required Health Insurance Benefits

State of Maryland

15-801Elderly individuals and individuals with Alzheimer's disease 15-802Treatment of mental illnesses, emotional disorders, and drug and alcohol misuse 15-803Payments for blood products 15-804Off-label use of drugs 15-805Prescribed pharmaceutical products 15-806Choice of pharmacy for filling prescriptions 15-807Medical foods and low protein modified food products 15-808Home health care 15-809Hospice care services 15-810In vitro fertilization procedures 15-810.1Iatrogenic infertility; coverage for standard fertility preservation procedures 15-811Hospitalization benefits for childbirth 15-812Inpatient hospitalization for mothers and newborn children 15-813Disabilities caused by pregnancy or childbirth 15-814Breast cancer screenings 15-814.1Copayment, coinsurance, or deductible requirements on coverage for diagnostic breast examinations or supplemental breast examinations 15-815Reconstructive breast surgery 15-816Routine gynecological care 15-817Child wellness services 15-818Treatment of cleft lip or cleft palate 15-819Corresponding outpatient services and second opinions 15-820Orthopedic braces 15-821Diagnostic or surgical procedures for bones of face, neck, and head 15-822Diabetes equipment, supplies, and outpatient self-management training and educational services 15-822.1Coverage for prescription insulin drugs under health insurance 15-823Prevention, diagnosis, and treatment of osteoporosis 15-824Receipt of 90-day supply of maintenance drug in a single dispensing of the prescription 15-825Prostate cancer diagnostic examinations 15-826Prescription contraceptive drugs or devices 15-826.1Prior authorization, copayment or coinsurance requirement for contraceptive drug or device prohibited 15-826.2Male sterilization 15-826.3Prevention of pregnancy by fertility awareness-based methods 15-827Patient costs of clinical trials 15-828General anesthesia and associated hospital or ambulatory facility charges in conjunction with dental care 15-829Chlamydia and human papilloma virus screening tests 15-830Referrals to specialists 15-831Prescription drugs or devices outside of formulary 15-832Surgical removal of testicle 15-832.1Inpatient hospitalization services following mastectomy 15-833Extension of benefits 15-834Prosthesis for enrollees or insureds having undergone a mastectomy 15-835Habilitative services for children 15-836Hair prostheses 15-837Colorectal cancer screening 15-838Hearing aids for children 15-838.1Hearing aids for adults 15-839Surgical treatment of morbid obesity 15-840Residential crisis services 15-841Tobacco product cessation aids or nicotine replacement therapy 15-842Copayments or coinsurance for covered prescription drug or device 15-843Amino-acid based elemental formulas 15-844Prostheses 15-845Prescription eye drops 15-846Orally administered cancer chemotherapy 15-847Specialty drug coverage and designated pharmacies 15-847.1Copayment for drug prescribed to treat diabetes, HIV, or AIDS 15-847.2Specialty drug coverage requirements; reimbursement rates 15-848Coverage for ostomy equipment and supplies 15-849Coverage requirements for abuse-deterrent opioid analgesic drug products 15-850Prior authorization requirement for an opioid antagonist 15-851Prior authorization requirement for drugs to treat opioid use disorders prohibited 15-852Prorated daily copayment or coinsurance amount for partial supply of prescription drug 15-853Coverage for diagnosis, evaluation, and treatment of lymphedema 15-854Prior authorization for prescription drugs 15-854.1Prior authorization of a course of treatment 15-855Coverage for pediatric autoimmune neuropsychiatric disorders and pediatric acute onset neuropsychiatric syndrome 15-856Abrogated by Acts 2021, 1st Sp. Sess., c. 29, § 5, eff. Jan. 1, 2023; Acts 2021, 1st Sp. Sess., c. 31, § 5, eff. Jan. 1, 2023 15-857Abortion care coverage 15-858Prescription drugs used as postexposure prophylaxis for prevention of HIV infection 15-859Biomarker testing 15-860Recommended lung cancer screening or follow-up diagnostic imaging to assist in the diagnosis of lung cancer 15-861Prior authorizations for transfer to special pediatric hospitals 15-862Coverage for delivery of anesthesia 15-863Coverage for calcium score testing