{"data":{"id":"us-nc/n.c.-gen.-stat.-58-51-50","jurisdiction":"us-nc","citation":"N.C. Gen. Stat. § 58-51-50","heading":"Coverage for chemical dependency treatment.","body":"(a)\tAs used in this section, the term \"chemical dependency\" means the pathological use or abuse of alcohol or other drugs in a manner or to a degree that produces an impairment in personal, social or occupational functioning and which may, but need not, include a pattern of tolerance and withdrawal.\n(b)\tEvery insurer that writes a policy or contract of group or blanket health insurance or group or blanket accident and health insurance that is issued, renewed, or amended on or after January 1, 1985, shall offer to its insureds benefits for the necessary care and treatment of chemical dependency that are not less favorable than benefits for physical illness generally. Except as provided in subsection (c) of this section, benefits for treatment of chemical dependency shall be subject to the same durational limits, dollar limits, deductibles, and coinsurance factors as are benefits for physical illness generally.\n(c)\tEvery group policy or group contract of insurance that provides benefits for chemical dependency treatment and that provides total annual benefits for all illnesses in excess of eight thousand dollars ($8,000) is subject to the following conditions:\n(1)\tThe policy or contract shall provide, for each 12-month period, a minimum benefit of eight thousand dollars ($8,000) for the necessary care and treatment of chemical dependency.\n(2)\tThe policy or contract shall provide a minimum benefit of sixteen thousand dollars ($16,000) for the necessary care and treatment of chemical dependency for the life of the policy or contract.\n(d)\tProvisions for benefits for necessary care and treatment of chemical dependency in group policies or group contracts of insurance shall provide benefit payments for the following providers of necessary care and treatment of chemical dependency:\n(1)\tThe following units of a general hospital licensed under Article 5 of General Statutes Chapter 131E:\na.\tChemical dependency units in facilities licensed after October 1, 1984;\nb.\tMedical units;\nc.\tPsychiatric units; and\n(2)\tThe following facilities or programs licensed after July 1, 1984, under Article 2 of General Statutes Chapter 122C:\na.\tChemical dependency units in psychiatric hospitals;\nb.\tChemical dependency hospitals;\nc.\tResidential chemical dependency treatment facilities;\nd.\tSocial setting detoxification facilities or programs;\ne.\tMedical detoxification or programs; and\n(3)\tDuly licensed physicians and duly licensed practicing psychologists and certified professionals working under the direct supervision of such physicians or psychologists in facilities described in (1) and (2) above and in day/night programs or outpatient treatment facilities licensed after July 1, 1984, under Article 2 of General Statutes Chapter 122C.\nProvided, however, that nothing in this subsection shall prohibit any policy or contract of insurance from requiring the most cost effective treatment setting to be utilized by the person undergoing necessary care and treatment for chemical dependency.\n(e)\tCoverage for chemical dependency treatment as described in this section shall not be applicable to any group policy holder or group contract holder who rejects the coverage in writing.\n(f)\tNotwithstanding any other provisions of this section, a group health benefit plan that covers both medical and surgical benefits and chemical dependency treatment benefits shall, with respect to the chemical dependency treatment benefits, comply with all applicable standards of Subtitle B of Title V of Public Law 110-343, known as the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008.\n(g)\tSubsection (f) of this section applies only to a group health benefit plan covering a large employer as defined in G.S. 58-68-25(a)(10). (1983 (Reg. Sess., 1984), c. 1110, s. 7; 1985, c. 589, s. 43(a), (b); 1989, c. 175, s. 1; 1991, c. 720, s. 64; 2009-382, s. 20.)","path":["Chapter 58. Insurance.","Article 51. Nature of Policies."],"source_url":"https://www.ncleg.gov/EnactedLegislation/Statutes/HTML/BySection/Chapter_58/GS_58-51-50.html","current_through":"S.L. 2026-30","vintage":"","retrieved_at":"2026-08-27T18:06:53Z","sha256":"e32a9a78bc9262188eb23648e71c659a3b94ecc5270826decc2358477bd4d88b","source_id":"us-nc","stale":false,"prev":"us-nc/n.c.-gen.-stat.-58-51-45","next":"us-nc/n.c.-gen.-stat.-58-51-55"},"notice":"GroundRules: Original legal text. Not legal advice."}