(a) Essential
health benefits are defined to include all of the following:
(1) Health benefits within the ten categories of
essential health benefits enumerated in subdivision (a)(1) of section 10112.27.
Provided that a stand-alone pediatric dental plan is certified to be offered on the
Exchange, a health insurer participating in the Exchange may, but is not required
to, omit coverage of the pediatric oral essential health benefit in a health
insurance policy sold on the Exchange, as permitted by section 1302(b)(4)(F) of
PPACA (42 U.S.C. §
18022(b)(4)(F)). A health
insurance policy sold on the Exchange shall not omit coverage of the pediatric oral
essential health benefit when sold outside of the Exchange pursuant to subdivision
(c)(1) of Insurance Code section
10112.3 or
otherwise.
(2) Medically necessary basic
health care services, as defined in subdivision (b) of section
1345 of
the Health and Safety Code and section
of Title
281300.67 of Title 28 of the California Code of
Regulations.
(3) The health benefits
mandated to be covered by the base-benchmark plan pursuant to all of the following:
(A) The sections of the Health and Safety Code
enumerated in subdivisions (a)(2)(A)(ii) and (a)(2)(A)(iv) of section
10112.27 of the
Insurance Code.
(B) Subdivision (a) of
section of
Title 281300.67.24 of Title 28 of the California
Code of Regulations.
(C) Section
of Title
281300.68.2 of Title 28 of the California Code of
Regulations.
(4) Durable
medical equipment for home use and prosthetic and orthotic devices covered by the
base-benchmark plan, including, but not limited to, all of the following:
(A) Diabetic Shoes and Inserts: off-the-shelf
depth-inlay shoes; custom-molded shoes; custom-molded multiple density inserts;
fitting, modification, and follow-up care for podiatric devices; repair or
replacement of podiatric devices.
(B)
Glucose Monitors, Infusion Pumps, and Related Supplies: external single or multiple
channel electric or battery-operated ambulatory infusion pumps; home blood glucose
monitors; blood glucose test or reagent strips for home blood glucose monitors;
interstitial glucose monitors; programmable and non-programmable implantable
infusion pumps; infusion pump used for uninterrupted parenteral administration of
medication; infusion sets for external insulin pumps; infusion supplies for external
drug infusion pumps; lancets; calibrator solution/chips; single or multi-channel
stationary parenteral infusion pumps; replacement batteries for home blood glucose
monitors and infusion pumps; spring-powered device for lancet; syringe with needle
for insulin pump.
(C) Respiratory Drug
Delivery Devices: large and small volume nebulizers; disposable and non-disposable
administration sets; aerosol compressors; aerosol mask; disposable and
non-disposable corrugated tubing for nebulizers; disposable and non-disposable
filters for aerosol compressors; peak expiratory flow rate meter; distilled water
for nebulizer; water collection device for nebulizer.
(D) Tracheostomy Equipment: artificial larynx;
replacement battery for artificial larynx; tracheo-esophageal voice prosthesis;
tracheostomy supplies, including: adhesive disc, filter, inner cannula, tube, tube
plug/stop, tube collar/holder, cleaning brush, mask, speaking valve, gauze, sterile
water, waterproof tape, and tracheostomy care kits.
(E) Canes and Crutches: adjustable and fixed
canes, including standard curved handle and quad canes; adjustable and fixed
crutches, including underarm and forearm crutches; replacement supplies for canes
and crutches, including handgrips, tips, and underarm pads.
(F) Dry pressure pad for a mattress.
(G) Cervical traction equipment (over
door).
(H) Osteogenesis Stimulation
Devices: non-invasive electrical osteogenesis stimulators, for spinal and non-spinal
applications; non-invasive low density ultrasound osteogenesis stimulator.
(I) Enteral and Parenteral Nutrition: enteral
formula and additives, adult and pediatric, including for inherited diseases of
metabolism; enteral feeding supply kits; enteral nutrition infusion pump; enteral
tubing; gastrostomy/jejunostomy tube and tubing adaptor; nasogastric tubing;
parenteral nutrition infusion pump; parenteral nutrition solutions; stomach tube;
supplies for self-administered injections.
(J) Hospital grade breast pump and double breast
pump kit.
(K) IV pole.
(L) Phototherapy (bilirubin) light with
photometer.
(M) Compression burn
garment; lymphedema gradient compression stocking; light compression bandage; manual
compression garment; moderate compression bandage.
(N) Non-segmental home model pneumatic compressor
for the lower extremities.
(O)
Prosthetic Devices Incident to Mastectomy: prosthetic devices incident to a
mastectomy, including custom-made prostheses when medically necessary; adhesive skin
support attachment for use with external breast prosthesis; and brassieres for
breast prostheses.
(P) Prosthetic
devices to replace all or part of an external facial body part that has been removed
or impaired as a result of disease, injury, or congenital
defect.
(5) Health benefits
covered by the base-benchmark plan not otherwise required to be covered under
Chapter 2.2 (commencing with section 1340) of Division 2 of the Health and Safety
Code, including, but not limited to, all of the following:
(A) Acupuncture services.
(B) Chemical dependency and substance use disorder
services.
(C) Contact lenses to treat
aniridia and aphakia.
(D) Health
benefits for prenatal diagnosis of fetal genetic disorders.
(E) Home hemodialysis and home peritoneal dialysis
equipment and medical supplies.
(F)
Mental health services.
(G) Nonemergency
licensed ambulance and psychiatric transport van services when the vehicle
transports the insured to or from covered services and the use of other means of
transportation may endanger the insured's health.
(H) Organ, tissue, or bone marrow transplant
donation services for an actual or potential living transplant donor, including for
harvesting of organs, tissue, or bone marrow and treatment of complications, when
the transplant recipient is covered by the health insurance policy.
(I) Ostomy and urological supplies:
(i) Ostomy supplies: adhesives; adhesive remover;
ostomy belt; hernia belts; catheter; skin wash/cleaner; bedside drainage bag and
bottle; urinary leg bags; gauze pads; irrigation faceplate; irrigation sleeve;
irrigation bag; irrigation cone/catheter; lubricant; urinary connectors; gas
filters; ostomy deodorants; drain tube attachment devices; gloves; stoma caps;
colostomy plug; ostomy inserts; urinary and ostomy pouches; barriers; pouch
closures; ostomy rings; ostomy face plates; skin barrier; skin sealant; waterproof
and non-waterproof tape.
(ii) Urological
supplies: adhesive catheter skin attachment; catheter insertion trays with and
without catheter and bag; male and female external collecting devices; male external
catheter with integral collection chamber; irrigation tubing sets; indwelling
catheters; foley catheters; intermittent catheters; cleaners; skin sealants; bedside
and leg drainage bags; bedside bag drainage bottle; catheter leg straps; irrigation
tray; irrigation syringe; lubricating gel; sterile individual packets; tubing and
connectors; catheter clamp or plug; penile clamp; urethral clamp or compression
device; waterproof and non-waterproof tape; catheter anchoring device.
(iii) Incontinence supplies for hospice patients:
disposable incontinence underpads; adult incontinence garments.
(J) Skilled nursing facility
services.
(6) Pediatric
services, including all of the following:
(A) The
following health benefits for pediatric oral care:
(i) Dental and orthodontic benefits covered by the
base-benchmark plan.
(ii) Dental
benefits covered by the Medi-Cal Dental Program.
(iii) Orthodontic benefits when medically
necessary to prevent disease and promote oral health, restore oral structures to
health and function, and treat emergency conditions.
(B) The following health benefits for pediatric
vision care:
(i) Vision benefits covered by the
base-benchmark plan.
(ii) Vision
benefits covered by the Federal Employees Dental and Vision Insurance Program
plan.