Oregon Statutes - Chapter 743A - Health Insurance: Required Reimbursements - Section 743A.160 - Alcoholism treatment.

A health insurance policy providing coverage for hospital or medical expenses not limited to expenses from accidents or specified sicknesses shall provide, at the request of the applicant, coverage for expenses arising from treatment for alcoholism. The following conditions apply to the requirement for such coverage:

(1) The applicant shall be informed of the applicantís option to request this coverage.

(2) The inclusion of the coverage may be made subject to the insurerís usual underwriting requirements.

(3) The coverage may be made subject to provisions of the policy that apply to other benefits under the policy, including but not limited to provisions relating to deductibles and coinsurance.

(4) The policy may limit hospital expense coverage to treatment provided by the following facilities:

(a) A health care facility licensed as required by ORS 441.015.

(b) A health care facility accredited by the Joint Commission on Accreditation of Hospitals.

(5) Except as permitted by subsection (3) of this section, the policy shall not limit payments thereunder for alcoholism to an amount less than $4,500 in any 24-consecutive month period and the policy shall provide coverage, within the limits of this subsection, of not less than 80 percent of the hospital and medical expenses for treatment for alcoholism. [Formerly 743.412]

Note: See 743.402.

Section:  Previous  743A.104  743A.108  743A.110  743A.120  743A.124  743A.140  743A.144  743A.148  743A.160  743A.164  743A.168  743A.180  743A.184  743A.188  743A.190  Next

Last modified: August 7, 2008