{"data":{"id":"us-tx/tex.-insurance-code-1357.004","jurisdiction":"us-tx","citation":"Tex. Insurance Code § 1357.004","heading":"COVERAGE REQUIRED.","body":"(a) A health benefit plan that provides coverage for mastectomy must provide coverage for:\n(1) reconstruction of the breast on which the mastectomy has been performed;\n(2) surgery and reconstruction of the other breast to achieve a symmetrical appearance; and\n(3) prostheses and treatment of physical complications, including lymphedemas, at all stages of mastectomy.\n(b) Coverage required under this section:\n(1) shall be provided in a manner determined to be appropriate in consultation with the attending physician and the enrollee;\n(2) may be subject to annual deductibles, copayments, and coinsurance that are consistent with annual deductibles, copayments, and coinsurance required for other coverage under the health benefit plan; and\n(3) may not be subject to dollar limits other than the lifetime maximum benefits under the plan.\nAdded by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.","path":["INSURANCE CODE","TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES","SUBTITLE E. BENEFITS PAYABLE UNDER HEALTH COVERAGES","CHAPTER 1357. MASTECTOMY","SUBCHAPTER A. RECONSTRUCTIVE SURGERY FOLLOWING MASTECTOMY"],"source_url":"https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1357.htm#1357.004","current_through":"89th 2nd Called Legislative Session, 2025","vintage":"","retrieved_at":"2026-08-27T01:47:21Z","sha256":"1115ad2807dc7f57c5ca81b0513d96fa247b3b2479dc0d850ca3ec414501fcca","source_id":"us-tx","stale":false,"prev":"us-tx/tex.-insurance-code-1357.003","next":"us-tx/tex.-insurance-code-1357.005"},"notice":"GroundRules: Original legal text. Not legal advice."}