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Texas Statutes (Last Updated: January 4, 2014) |
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INSURANCE CODE |
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Title 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES |
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Subtitle E. BENEFITS PAYABLE UNDER HEALTH COVERAGES |
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Chapter 1357. MASTECTOMY |
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Subchapter A. RECONSTRUCTIVE SURGERY FOLLOWING MASTECTOMY |
Sec. 1357.003. EXCEPTION
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This subchapter does not apply to:
(1) a plan that provides coverage:
(A) only for a specified disease or another limited benefit, other than benefits for cancer;
(B) only for accidental death or dismemberment;
(C) only for wages or payments in lieu of wages for a period during which an employee is absent from work because of sickness or injury;
(D) only for credit insurance;
(E) only for dental or vision care;
(F) only for indemnity for hospital confinement; or
(G) as a supplement to a liability insurance policy;
(2) a Medicare supplemental policy as defined by Section 1882(g)(1), Social Security Act (42 U.S.C. Section 1395ss), as amended;
(3) a workers' compensation insurance policy;
(4) medical payment insurance coverage provided under a motor vehicle insurance policy; or
(5) a long-term care insurance policy, including a nursing home fixed indemnity policy, unless the commissioner determines that the policy provides benefit coverage so comprehensive that the policy is a health benefit plan as described by Section 1357.002.