Mandates cover various services

Rhode Island law mandates health insurance coverage of several services and treatments, with exceptions for some very limited types of policies.

Here are some of the mandates:

– Mammograms and pap smears: In accordance with American Cancer Society guidelines.

– Lyme disease: Diagnostic testing and long-term antibiotic treatment of chronic Lyme disease when determined to be medically necessary by a doctor after a “thorough evaluation” of the patient; includes treatments considered “unproven, experimental or investigational.”

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– Diabetes treatment: Physician services and, if medically appropriate and prescribed by a doctor, blood glucose monitors and blood glucose monitors for the legally blind, test strips for glucose monitors and/or visual reading, insulin, injection aids, cartridges for the legally blind, syringes, insulin pumps and appurtenances to the pumps, insulin infusion devices, oral agents for controlling blood sugar, and special shoes to prevent amputation.

– Mastectomy treatment: Breast reconstruction after a mastectomy, including surgery of the other breast to produce a symmetrical appearance. Also, prostheses and treatment of any complications.

– Bone marrow donor testing: Human leukocyte antigen testing for A, B, and DR antigens for utilization in bone marrow transplantation. Tests must be in an accredited facility, and the results must be registered with the National Marrow Donor Program.

– Contraceptives: FDA-approved contraceptive drugs and devices requiring a prescription, except there’s no requirement to cover RU 486 (the “morning after pill”).

– Hearing aids: $1,000 per hearing aid per year, every three years, for children under 18; for adults, hearing aid coverage can be provided as an optional rider.

– Prostate and colorectal exams: Exams and lab tests for cancer for any non-symptomatic person in accordance with American Cancer Society guidelines.

– Marriage and family counselors: Certified counselors in mental health and therapists in marriage and family practice, in conjunction with diagnosis of a mental disorder.

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