§ 58‑3‑280. Coverage for the diagnosis and treatment of lymphedema.
(a) Every healthbenefit plan, as defined in G.S. 58‑3‑167, shall provide coveragefor the diagnosis, evaluation, and treatment of lymphedema. The coveragerequired by this section shall include benefits for equipment, supplies,complex decongestive therapy, gradient compression garments, and self‑managementtraining and education, if the treatment is determined to be medicallynecessary and is provided by a licensed occupational or physical therapist orlicensed nurse that has experience providing this treatment, or other licensedhealth care professional whose treatment of lymphedema is within theprofessional's scope of practice.
(b) The samedeductibles, coinsurance, and other limitations as apply to similar servicescovered under the health benefit plan apply to coverage for the diagnosis,evaluation, and treatment of lymphedema required to be covered under thissection. Nothing in this section requires a health benefit plan to provide aseparate set of benefit limitations or maximums for the diagnosis, evaluation,or treatment of lymphedema.
(c) As used in thissection, gradient compression garments:
(1) Require aprescription;
(2) Are custom‑fitfor the covered individual; and
(3) Do not includedisposable medical supplies such as over‑the‑counter compression orelastic knee‑high or other stocking products. (2009‑313, s. 1.)
§ 58‑3‑280. Coverage for the diagnosis and treatment of lymphedema.
(a) Every healthbenefit plan, as defined in G.S. 58‑3‑167, shall provide coveragefor the diagnosis, evaluation, and treatment of lymphedema. The coveragerequired by this section shall include benefits for equipment, supplies,complex decongestive therapy, gradient compression garments, and self‑managementtraining and education, if the treatment is determined to be medicallynecessary and is provided by a licensed occupational or physical therapist orlicensed nurse that has experience providing this treatment, or other licensedhealth care professional whose treatment of lymphedema is within theprofessional's scope of practice.
(b) The samedeductibles, coinsurance, and other limitations as apply to similar servicescovered under the health benefit plan apply to coverage for the diagnosis,evaluation, and treatment of lymphedema required to be covered under thissection. Nothing in this section requires a health benefit plan to provide aseparate set of benefit limitations or maximums for the diagnosis, evaluation,or treatment of lymphedema.
(c) As used in thissection, gradient compression garments:
(1) Require aprescription;
(2) Are custom‑fitfor the covered individual; and
(3) Do not includedisposable medical supplies such as over‑the‑counter compression orelastic knee‑high or other stocking products. (2009‑313, s. 1.)
§ 58‑3‑280. Coverage for the diagnosis and treatment of lymphedema.
(a) Every healthbenefit plan, as defined in G.S. 58‑3‑167, shall provide coveragefor the diagnosis, evaluation, and treatment of lymphedema. The coveragerequired by this section shall include benefits for equipment, supplies,complex decongestive therapy, gradient compression garments, and self‑managementtraining and education, if the treatment is determined to be medicallynecessary and is provided by a licensed occupational or physical therapist orlicensed nurse that has experience providing this treatment, or other licensedhealth care professional whose treatment of lymphedema is within theprofessional's scope of practice.
(b) The samedeductibles, coinsurance, and other limitations as apply to similar servicescovered under the health benefit plan apply to coverage for the diagnosis,evaluation, and treatment of lymphedema required to be covered under thissection. Nothing in this section requires a health benefit plan to provide aseparate set of benefit limitations or maximums for the diagnosis, evaluation,or treatment of lymphedema.
(c) As used in thissection, gradient compression garments:
(1) Require aprescription;
(2) Are custom‑fitfor the covered individual; and
(3) Do not includedisposable medical supplies such as over‑the‑counter compression orelastic knee‑high or other stocking products. (2009‑313, s. 1.)
