Medical food coverage 24-A M.R.S.A. Must provide coverage for metabolic formula and up to the actuarial ☐ for inborn error of equivalent of $3,000 per year for prescribed modified low-protein food metabolism products. Mental Health 24-A M.R.S.A. Must provide, at a minimum, the following benefits for a person ☐ Coverage suffering from a mental or nervous condition: inpatient services, day treatment services, outpatient services, and home health care services. For groups with more than 20 employees mental health benefits cannot be less extensive than for physical illnesses for the following mental illnesses: psychotic disorders (including schizophrenia), dissociative disorders, mood disorders, anxiety disorders, personality disorders, paraphilias, attention deficit ad disruptive behavior disorders, pervasive developmental disorders, tic disorders, eating disorders (including bulimia and anorexia), and substance abuse-related disorders. Mental health services Mandated offer of parity for small groups mental health benefits ☐ – (groups of 20 or less) cannot be less extensive than for physical illnesses for the following mental illnesses: schizophrenia, bipolar disorder, pervasive developmental disorder (or autism), paranoia, panic disorder, obsessive compulsive disorder, and major depressive disorder. Mental health services Benefits must be made available for mental health services provided by ☐ provided by licensed counselors. counseling professionals. Obstetrical and 24-A M.R.S.A. Benefits must be provided for annual gynecological exam without ☐ gynecological care prior approval of primary care physician. A group health plan, or health insurance issuer offering group or individual health insurance coverage, described in paragraph (2) may not require authorization or referral by the plan, issuer, or any person (including a primary care provider described in paragraph (2)(B)) in the case of a female participant, beneficiary, or enrollee who seeks coverage for obstetrical or gynecological care provided by a participating health care professional who specializes in obstetrics or gynecology. Off-label use of 24-A M.R.S.A. Coverage required for off-label use of prescription drugs for treatment ☐ prescription drugs for of cancer, HIV, or AIDS.
Medical food coverage for inborn error of metabolism 24-A M.R.S.A. Must provide coverage for metabolic formula and up to the actuarial equivalent of $3,000 per year for prescribed modified low-protein food products. ☐ Mental Health Coverage 24-A M.R.S.A. Must provide, at a minimum, the following benefits for a person suffering from a mental or nervous condition: inpatient services, day treatment services, outpatient services, and home health care services. For groups with more than 20 employees mental health benefits cannot be less extensive than for physical illnesses for the following mental illnesses: psychotic disorders (including schizophrenia), dissociative disorders, mood disorders, anxiety disorders, personality disorders, paraphilias, attention deficit ad disruptive behavior disorders, pervasive developmental disorders, tic disorders, eating disorders (including bulimia and anorexia), and substance abuse-related disorders. ☐ Mental health services (groups of 20 or less) Mandated offer of parity for small groups – mental health benefits cannot be less extensive than for physical illnesses for the following mental illnesses: schizophrenia, bipolar disorder, pervasive developmental disorder (or autism), paranoia, panic disorder, obsessive compulsive disorder, and major depressive disorder. ☐ Mental health services provided by counseling professionals. Benefits must be made available for mental health services provided by licensed counselors. ☐ Obstetrical and gynecological care 24-A M.R.S.A. Benefits must be provided for annual gynecological exam without prior approval of primary care physician. A group health plan, or health insurance issuer offering group or individual health insurance coverage, described in paragraph (2) may not require authorization or referral by the plan, issuer, or any person (including a primary care provider described in paragraph (2)(B)) in the case of a female participant, beneficiary, or enrollee who seeks coverage for obstetrical or gynecological care provided by a participating health care professional who specializes in obstetrics or gynecology. ☐ Off-label use of prescription drugs for 24-A M.R.S.A. Coverage required for off-label use of prescription drugs for treatment of cancer, HIV, or AIDS. ☐
group_similar_supplementa.docx