SB250 Alabama 2014 Session

Summary

Primary Sponsor

Harri Anne Smith

Republican

Session

Regular Session 2014

Title

Health benefit plans, breast cancer reconstruction surgery, coverage required on health benefit plans after a mastectomy, Secs. 10A-20-6.16, 27-21A-23 am'd

Summary

SB250 would require health benefit plans in Alabama to cover breast reconstruction after mastectomy.

What This Bill Does

If passed, the bill would require all health benefit plans executed or renewed in Alabama to cover all stages of breast reconstruction after mastectomy, including surgery on the affected breast and reconstruction of the other breast for symmetry, plus prostheses and related complications like lymphedema. The coverage would use the same deductibles, copayments, or coinsurance as other plan benefits and written notice of availability must be provided to enrollees at policy initiation and annually thereafter. It also applies to plans based outside Alabama if they transact claims for Alabama residents and prohibits actions that would avoid compliance or otherwise undermine these protections.

Who It Affects

• Policyholders and beneficiaries in Alabama who undergo mastectomy would gain mandated coverage for breast reconstruction.
• Insurers, HMOs, and other health benefit plan sponsors operating in Alabama (including some out-of-state plans that handle Alabama claims) would be required to provide this coverage and follow the new rules.

Key Provisions

• Coverage requirement: All health benefit plans executed or renewed in Alabama must cover breast reconstruction after mastectomy, including all stages of reconstruction for the operated breast and reconstruction of the other breast for symmetry.
• Scope: Applies to in-state plans and certain out-of-state plans that transact in Alabama; defines health benefit plan for purposes of this act.
• Cost sharing and notice: Coverage may use the same deductibles and coinsurance as other benefits; written notice of coverage must be delivered at policy inception and annually.
• Protections: Prohibits denying eligibility/renewal to avoid compliance, prohibits incentives to discourage protections or to influence provider behavior, and prohibits restrictive actions during hospital stays that would undermine coverage.

AI-generated summary using openai/gpt-5-nano on Feb 24, 2026. May contain errors — refer to the official bill text for accuracy.

Subjects

Insurance