{"data":{"id":"us-ky/krs-304.18-0983","jurisdiction":"us-ky","citation":"KRS 304.18-0983","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 group or blanket health insurance policies an d certificates in\nthis Commonwealth providing coverage on an expense -incurred basis shall make\navailable and offer to the purchaser coverage for:\n(a) The following, if an insurer provides medical and surgical benefits with\nrespect to a mastectomy, in a man ner determined in consultation 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 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 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 provide r, in accordance with standard 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 which requires the procedure 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-6; and\n(b) Penalize or otherwise reduce or limit the reimb ursement 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-6.","path":[],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=29441","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:57:49Z","sha256":"90e3b4216b9e260301c3777f5d51e1772960b8e5e4d1e7b8025f66e9f7ea3f48","source_id":"us-ky","stale":false,"prev":"us-ky/krs-304.18-098","next":"us-ky/krs-304.18-0985"},"notice":"GroundRules: Original legal text. Not legal advice."}