Section 1357.004 - Coverage Required(a) A health benefit plan that provides coverage for mastectomy must provide coverage for: (1) reconstruction of the breast on which the mastectomy has been performed;(2) surgery and reconstruction of the other breast to achieve a symmetrical appearance; and(3) prostheses and treatment of physical complications, including lymphedemas, at all stages of mastectomy.(b) Coverage required under this section:(1) shall be provided in a manner determined to be appropriate in consultation with the attending physician and the enrollee;(2) may be subject to annual deductibles, copayments, and coinsurance that are consistent with annual deductibles, copayments, and coinsurance required for other coverage under the health benefit plan; and(3) may not be subject to dollar limits other than the lifetime maximum benefits under the plan.Tex. Ins. Code § 1357.004
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. 4/1/2005.