Idaho Administrative Code
Title IDAPA 18 - Insurance, Department of
Rule 18.04.02 - RULE TO IMPLEMENT UNIFORM COVERAGE FOR NEWBORN AND NEWLY ADOPTED CHILDREN
Section 18.04.02.011 - COVERAGE REQUIREMENTS OF NEWBORN AND NEWLY ADOPTED CHILDREN
Current through August 31, 2023
01. Coverage. A health plan will provide coverage to: (3-31-22)
02. Coverage Requirements. Coverage of newborn and newly adopted children will be at least equivalent to the coverage afforded other health plan members under the health plan and include coverage for the medically necessary care and treatment of congenital anomalies. (3-31-22)
03. Pre-Existing Conditions. A health plan cannot apply a pre-existing condition exclusion to a newborn or newly adopted child. (3-31-22)
04. Reconstructive Surgery. A health plan will not exclude reconstructive surgery for congenital anomalies. (3-31-22)
05. Limitations on Coverage for Congenital Anomalies. A health plan may apply exclusions, requirements or benefit limitations, including cost sharing requirements, to coverage for congenital anomalies that are consistent with the requirements of this chapter and no more restrictive than exclusions, requirements or benefit limitations applied to coverage for similar treatments, conditions and services provided under the health plan. (3-31-22)
06. Notification and Payment. (3-31-22)
07. Portability. The coverage provided by this section applies to any subsequent health plans providing coverage to the newborn or newly adopted child. (3-31-22)