Iowa Admin. Code r. 191-80.5

Current through Register Vol. 47, No.14, January 8, 2025

Rule 191-80.5 - Benefit plan

(1) Every group accident and sickness insurance policy, group nonprofit health service plan or prepaid group plan of a health maintenance organization shall provide benefits for well-child care for any child covered by the policy or contract at approximately the following age intervals: birth, 2 weeks, 2 months, 4 months, 6 months, 9 months, 12 months, 15 months, 18 months, 24 months or two years, three years, four years, five years and six years.

(2) Minimum benefits may be limited to one visit payable to one provider for all services provided at each visit cited in this rule.

(3) Benefits shall be subject to any policy provisions which apply to other services covered by such policy, except as set forth in 80.5(5).

(4) This rule does not apply to disability income, specified disease, Medicare supplement, hospital indemnity, long-term care or trip/travel policies.

(5) The provisions of this benefit will supersede any deductible requirements.

Iowa Admin. Code r. 191-80.5

Amended by IAB December 29, 2021/Volume XLIV, Number 13, effective 2/2/2022