§ 1902. Mandatory plan coverage
A health care insurer that offers, issues for delivery, delivers, executes, adjusts, uses, or renews a health care insurance plan shall provide coverage for the costs of telemedicine services and treatment that arc medically necessary.
§ 1802. Coverage for hearing aid
(a) An individual or group health insurance policy, health care plan or certificate of health insurance that is delivered, issued for delivery or renewed in the Virgin Islands must provide coverage for a hearing aid and any related services for the full cost of one hearing aid per hearing-impaired ear up to $2,200 per ear, […]
§ 1803. Additional coverage; benefits included
(a) An insurer that delivers, issues for delivery or renews in the Virgin Islands an individual or group health insurance policy, health care plan or certificate of health insurance may make available to the policyholder the option of purchasing additional hearing aid coverage that exceeds the services described in this section. (b) Hearing aid coverage […]
§ 1804. Deductibles and coinsurance
Coverage for hearing aids may be subject to deductibles and coinsurance consistent with those imposed on other benefits under the same policy, plan or certificate.
§ 1805. Exclusions
This subchapter does not apply to short-term travel, accident-only or limited or specified disease policies.
§ 1801. Definitions
For the purposes of this subchapter the term, (1) “Children” means persons under the under eighteen years of age, or under twenty-one years of age if still attending high school. (2) “Hearing aid” means durable medical equipment that is of a design and circuitry to compensate for impaired human hearing and optimize audibility and listening […]
§ 1724. Initial billing
(a) If a patient, at the time of requesting health care services, presents to the health care provider evidence of coverage by a recognized health insurer, then the health care provider shall apply the following procedure when requiring payment for any services rendered: (1) The health care provider may require payment at or before the […]
§ 1725. Prompt payment by insurer
(a) Any insurer providing health insurance coverage shall be required to process and pay any uncontested claim, within thirty (30) calendar days from the date of receiving the claim. (b) If there is a contested claim, the insurer shall, within the same thirty (30) day calendar period notify the health care provider of its decision […]
§ 1726. Information and dispute resolution requirements
(a) Each insurer providing coverage under a health insurance plan shall establish and maintain an accessible information service which health care providers may contact telephonically and electronically to ascertain immediately whether a patient, service or procedure is covered under the plan, and whether a patient has satisfied any deductible amounts under the plan. The health […]
§ 1727. Failure to comply; penalties
(a) Any health care provider or recognized health insurer who willfully violate the provisions of this chapter shall be subject to the following penalties: (1) A health care provider or recognized health insurer who intentionally or negligently fails to comply with the provisions of this chapter shall be fined by the Commissioner not less than […]