{"data":{"id":"us-ky/krs-304.17a-134","jurisdiction":"us-ky","citation":"KRS 304.17A-134","heading":"Coverage for medical and surgical benefits with respect to","body":"mastectomy, diagnosis and treatment of endometrioses and endometritis, and\nbone density testing -- Requirements for health benefit plan.\n(1) A health benefit plan shall make available and offer to the purchaser coverage for:\n(a) The following, if a health benefit plan provides medical and surgical benefits\nwith respect to mastectomy, in a manner determined in consultation with the\nattending physician and the covered person, and subject to a nnual 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 the\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 health\nbenefit plan also covers 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 standard medical\npractice, to obtain baseline data for the purpose  of early detection of\nosteoporosis.\n(2) No health benefit plan under this section shall offer medical and surgical benefits\nwith respect to a mastectomy that requires the procedure be performed on an\noutpatient basis.\n(3) A health benefit plan shall provi de written notice to a covered person of the\navailability of medical and surgical benefits with respect to a mastectomy upon\nenrollment and annually thereafter.\n(4) A health benefit plan shall not:\n(a) Deny eligibility, or continued eligibility, to an indi vidual 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=17369","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:57:46Z","sha256":"e92836cfbdd84fd0770fec104d1e988d3dcbb22105f85fe13aeb516cb000ddd8","source_id":"us-ky","stale":false,"prev":"us-ky/krs-304.17a-133","next":"us-ky/krs-304.17a-135"},"notice":"GroundRules: Original legal text. Not legal advice."}