048-3 Wyo. Code R. § 3-3

Current through April 27, 2019

Section 3-3 - Basic Level of Benefits

(a) The HHS Secretary-approved benefits provided to targeted low-income children eligible for Kid Care CHIP shall include, at a minimum, the following services:

• (i) Inpatient hospital services

• (ii) Outpatient hospital services

• (iii) Physician services

• (iv) Surgical services

• (v) Clinic services and other ambulatory health care services

• (vi) Prescription drugs

• (vii) Laboratory and radiological services

• (viii) Prenatal care and pre-pregnancy family planning services and supplies

• (ix) Inpatient mental health services

• (x) Outpatient mental health services

• (xi) Dental services

• (xii) Medically necessary orthodontia

• (xiii) Abortion, only if necessary to save the life of the mother or if the pregnancy is the result of rape or incest

• (xiv) Inpatient substance abuse treatment

• (xv) Outpatient substance abuse treatment

• (xvi) Durable medical equipment

• (xvii) Preventive care, screening and immunization

• (xviii) Hospice care

• (xix) Emergency medical transportation

• (xx) Vision services

• (xxi) Any other additional or different services required by the Request for Proposal for health benefits, and resulting contract.

(b) Except as otherwise specified, coverage shall be one hundred percent (100%) with no deductible or co-payment. Co-payments by insureds or their families shall be in compliance with Chapter 4.

(c) Any recommended/approved plan for targeted low-income eligible children shall not contain any exclusion for pre-existing conditions or a maximum life-time benefit per child.

048-3 Wyo. Code R. § 3-3