{"data":{"id":"us-ky/krs-304.17-3163","jurisdiction":"us-ky","citation":"KRS 304.17-3163","heading":"Coverage for medical and surgical benefits with respect to","body":"mastectomy, diagnosis and treatment of endometrioses and endometritis, and\nbone density testing -- Duties of insurer.\n(1) All insurers issuing individual health insurance policies in this Commonwealth\nproviding coverage on an expense -incurred basis shall make available and offer to\nthe purchaser coverage for:\n(a) The following, if an insurer provides medical and surgical benefits with\nrespect to mastectomy, in a manner determined in consult ation with the\nattending physician and the covered person, and subject to annual deductibles\nand coinsurance provisions as may be deemed appropriate and as are\nconsistent with those established for other benefits under the coverage:\n1. All stages of breast  reconstruction surgery of the breast on which a\nmastectomy has been performed;\n2. Surgery and reconstruction of the other breast to produce a symmetrical\nappearance; and\n3. Prostheses and physical complications of all stages of mastectomy,\nincluding lymphedemas;\n(b) Diagnosis and treatment of endometriosis and endometritis if the insurer also\ncovers hysterectomies; and\n(c) Bone density testing for women age thirty -five (35) years and older, as\nindicated by the health -care provider, in accordance with stand ard medical\npractice, to obtain baseline data for the purpose of early detection of\nosteoporosis.\n(2) No insurer under this section shall offer medical and surgical benefits with respect\nto a mastectomy that requires the procedure to be performed on an outpatient basis.\n(3) An insurer shall provide written notice to a covered person of the availability of\nmedical and surgical benefits with respect to a mastectomy upon enrollment and\nannually thereafter.\n(4) An insurer shall not:\n(a) Deny eligibility, or continued eligibility, to an individual to enroll or to renew\ncoverage under the terms of the plan, solely for the purpose of avoiding the\nrequirements of 42 U.S.C. sec. 300gg-52; and\n(b) Penalize or otherwise reduce or limit the reimbursement of an attending\nprovider, or provide incentives to an attending provider, to induce the provider\nto provide care to an individual in a manner inconsistent with 42 U.S.C. sec.\n300gg-52.","path":[],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=17327","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:57:45Z","sha256":"55a09321602364d6dca2cf84921d71599d7c81008956f65c2feaf68f64056aff","source_id":"us-ky","stale":false,"prev":"us-ky/krs-304.17-316","next":"us-ky/krs-304.17-3165"},"notice":"GroundRules: Original legal text. Not legal advice."}