P.R. Laws tit. 24, § 3526

2019-02-20 00:00:00+00
§ 3526. Health insurance coverage

(a) Except as provided hereinbelow, any health insurance policy which is available or may be available, renewed, extended, or modified in Puerto Rico by any health insurance company with benefits applicable within the health insurance policy, shall include coverage for initial hearing screening and for any other hearing evaluation within the follow-up care related to the hearing screening described in this chapter.

(b) Except as provided hereinbelow, if a health insurance company provides coverage or benefits to the residents of Puerto Rico, it shall be understood that the service shall be rendered in Puerto Rico, as provided by this chapter, even though the company is located outside of Puerto Rico.

(c) The benefits of the universal neonatal hearing screening test to newborn babies, as well as the follow-up care shall be subject to the same co-payment policies and co-insured provisions applicable to any other medical service. With the exception that the benefit of neonatal hearing screening shall be exempted from co-payments or provisions that limit the maximum amount to be paid by the insurer.

(d) Notwithstanding subsections (a) and (b), this section shall not be construed as a requirement for the insurance company to cover the expenses of hearing screening to newborn babies whose parents are not residents of Puerto Rico, if the parents are employed outside Puerto Rico and their employer has health insurance included as one of the employee’s benefits.

(e) This chapter shall apply to all insurance companies, individual or of any other kind, contracts to subscribers and certificates of insurance companies issued to any group as policy, that are or will be available on or after this act takes effect.

History —Dec. 19, 2003, No. 311, § 7, eff. 30 days after Dec. 19, 2003.