Preventive health 24-A M.R.S.A. Must, at a minimum, provide coverage for, and may not impose ☐ services sharing requirements for, the following preventive services: PHSA §2713 Preventive health (75 Fed Reg The evidence-based items or services that have a rating of A or B in services without the recommendations of the USPSTF or equivalent rating from a requirements 45 CFR successor organization; including deductibles, §147.130) With respect to the individual insured, immunizations that have a and recommendation from the federal DHHS, CDC, Advisory Committee on Immunization Practices; With respect to infants, children and adolescents, preventive care and screenings provided for in the most recent version of the comprehensive guidelines supported by the federal DHHS, HRSA; and With respect to such additional preventive care and screenings not described in paragraph A, provided for in the comprehensive guidelines supported by the federal DHHS, HRSA women's preventive services guidelines. If one of the recommendations referenced above is changed during a plan year, a carrier is not required to make changes to that health plan during the plan year. SEE SEPARATE CHECKLIST FOR SPECIFIC SERVICES. Prostate cancer screening 24-A M.R.S.A. Coverage required for prostate cancer screening: Digital rectal ☐ examinations and prostate-specific antigen tests covered if recommended by a physician, at least once a year for men 50 years of age or older until age 72. Reconstructive surgery 24-A M.R.S.A. If covers mastectomy, then must also cover reconstructive surgery in a ☐ after mastectomy manner determined in consultation with provider and patient. Coverage PHSA §2727 must include: ☐ Reconstruction of the breast on which the mastectomy was performed (all stages);
Preventive health services Preventive health services without requirements including deductibles, and 24-A M.R.S.A. PHSA §2713 (75 Fed Reg 45 CFR §147.130) Must, at a minimum, provide coverage for, and may not impose requirements for, the following preventive services: The evidence-based items or services that have a rating of A or B in the recommendations of the USPSTF or equivalent rating from a successor organization; With respect to the individual insured, immunizations that have a recommendation from the federal DHHS, CDC, Advisory Committee on Immunization Practices; With respect to infants, children and adolescents, preventive care and screenings provided for in the most recent version of the comprehensive guidelines supported by the federal DHHS, HRSA; and With respect to such additional preventive care and screenings not described in paragraph A, provided for in the comprehensive guidelines supported by the federal DHHS, HRSA women's preventive services guidelines. If one of the recommendations referenced above is changed during a plan year, a carrier is not required to make changes to that health plan during the plan year. SEE SEPARATE CHECKLIST FOR SPECIFIC SERVICES. ☐ Prostate cancer screening 24-A M.R.S.A. Coverage required for prostate cancer screening: Digital rectal examinations and prostate-specific antigen tests covered if recommended by a physician, at least once a year for men 50 years of age or older until age 72. ☐ Reconstructive surgery after mastectomy 24-A M.R.S.A. PHSA §2727 If covers mastectomy, then must also cover reconstructive surgery in a manner determined in consultation with provider and patient. Coverage must include: Reconstruction of the breast on which the mastectomy was performed (all stages); ☐ ☐ sharing
individual_major_medical_plans-non-grandfathered.docx