It
is important to note that Virginia’s insurance laws require
that most health insurance plans, including Managed Care Health
Insurance Plans (MCHIPs): 1) provide certain benefits, known
as mandated benefits, in each and every individual or group
contract they offer in Virginia; and 2) offer and make available
to you, as an individual policyholder, or your employer, if
you have group coverage, the option to purchase certain benefits
known as mandated offers of coverage. Mandates apply only
to Virginia-issued contracts or policies.
If
you wish to read any of the specific mandated benefit or mandated
offer statutes, simply click on the code citation below.
§38.2-3408
Reimbursement for services provided by certain practitioners
other than physicians
§38.2-3409
Coverage for dependent children
§38.2-3410
Terms "physician" and "doctor" to include
dentist
§38.2-3411
Coverage of newborn children
§38.2-3411.2
Coverage of adopted children required
§38.2-3411.3
Coverage for Childhood Immunizations
§38.2-3411.4
Coverage for infant hearing screening and related diagnostics
§38.2-3412.1
Coverage for mental health and substance abuse services
§38.2-3412.1:01
Coverage for biologically based mental illness
§38.2-3414.1
Coverage for postpartum services
§38.2-3415
Exclusion or reduction of benefits for certain causes prohibited
§38.2-3416
Insurer required to offer conversion policy or group coverage
§38.2-3418
Coverage for victims of rape and incest
§38.2-3418.1
Coverage for mammograms
§38.2-3418.1:2
Coverage for pap smears
§38.2-3418.2
Coverage of procedures involving bones and joints
§38.2-3418.3
Coverage for hemophilia and congenital bleeding disorders
§38.2-3418.4
Coverage for reconstructive breast surgery
§38.2-3418.5
Coverage for early intervention services
§38.2-3418.6
Minimal hospital stays mastectomy, certain lymph node dissection
patients
§38.2-3418.7
Coverage for PSA (prostate-specific antigen) testing
§38.2-3418.7:1
Coverage for Colorectal Cancer Screenings
§38.2-3418.8
Coverage for clinical trials for treatment studies on cancer
§38.2-3418.9
Minimum hospital stays for hysterectomy
§38.2-3418.10
Coverage for diabetes
§38.2-3418.11
Coverage for hospice care
§38.2-3418.12
Coverage for Hospitalization and Anethesia for dental procedures
§38.2-3418.14
Coverage for Lymphedema
Mandated
Offers of Coverage
§38.2-3407.5:1
Coverage for Prescription Contraceptives
§38.2-3411.1
Coverage for child health supervision services
§38.2-3414
Optional coverage for obstetrical services
§38.2-3417
Deductible and coinsurance options required
§38.2-3418.1:1
Coverage for bone marrow transplants
§38.2-3418.13
Coverage for Morbid Obesity
You may
contact The
Office of the Managed Care Ombudsman
for detailed information about these mandates or you may refer
to Title
38.2
of the Code of Virginia.
