Ch. 35

1997 LAWS OF MARYLAND

(I) SHALL BE PROVIDED AS ONE SET OF BENEFITS COVERING
MENTAL ILLNESSES, EMOTIONAL DISORDERS, DRUG ABUSE, AND ALCOHOL ABUSE;

(II) SHALL HAVE THE SAME TERMS AND CONDITIONS AS THE
BENEFITS FOR PHYSICAL ILLNESSES COVERED UNDER THE POLICY OR CONTRACT
SUBJECT TO THIS SECTION, EXCEPT AS SPECIFICALLY PROVIDED IN THIS SECTION;

AND

(III) MAY BE DELIVERED UNDER A MANAGED CARE SYSTEM.

(3) EXCEPT FOR THE COINSURANCE REQUIREMENTS UNDER
SUBSECTION (D)(3) OF THIS SECTION, A POLICY OR CONTRACT SUBJECT TO THIS
SECTION MAY NOT HAVE:

(I) SEPARATE LIFETIME MAXIMUMS FOR PHYSICAL ILLNESSES
AND ILLNESSES COVERED UNDER THIS SECTION;

(II) SEPARATE DEDUCTIBLES AND COINSURANCE AMOUNTS FOR
PHYSICAL ILLNESSES AND ILLNESSES COVERED UNDER THIS SECTION; OR

(III) SEPARATE OUT-OF-POCKET LIMITS IN A BENEFIT PERIOD OF
NOT MORE THAN 12 MONTHS FOR PHYSICAL ILLNESSES AND ILLNESSES COVERED
UNDER THIS SECTION.

(4) ANY COPAYMENTS REQUIRED UNDER A POLICY OR CONTRACT
SUBJECT TO THIS SECTION FOR BENEFITS FOR ILLNESSES COVERED UNDER THIS
SECTION SHALL BE:

(I) ACTUARIALLY EQUIVALENT TO ANY COINSURANCE
REQUIREMENTS UNDER THIS SECTION; OR

(II) IF THERE ARE NO COINSURANCE REQUIREMENTS, NOT
GREATER THAN ANY COPAYMENT REQUIRED UNDER THE POLICY OR CONTRACT
FOR A BENEFIT FOR A PHYSICAL ILLNESS.

(F) OFFICE VISITS.

AN OFFICE VISIT TO A PHYSICIAN OR OTHER HEALTH CARE PROVIDER FOR
MEDICATION MANAGEMENT;

(1) MAY NOT BE COUNTED AGAINST THE NUMBER OF VISITS REQUIRED
TO BE COVERED AS A PART OF THE BENEFITS REQUIRED UNDER SUBSECTION (D)(3)
OF THIS SECTION; AND

(2) SHALL BE REIMBURSED UNDER THE SAME TERMS AND CONDITIONS
AS AN OFFICE VISIT FOR A PHYSICAL ILLNESS COVERED UNDER THE POLICY OR
CONTRACT SUBJECT TO THIS SECTION.

(G) EFFECT OF SECTION.

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