Texas § IN.1366.055 - COVERAGE FOR INPATIENT CARE REQUIRED

§ IN.1366.055. COVERAGE FOR INPATIENT CARE REQUIRED

COVERAGE FOR INPATIENT CARE REQUIRED. (a) Except as provided by Subsection (b), a health benefit plan that provides maternity benefits, including benefits for childbirth, must provide to a woman who has given birth to a child and the newborn child coverage for inpatient care in a health care facility for not less than: (1) 48 hours after an uncomplicated vaginal delivery; and (2) 96 hours after an uncomplicated delivery by cesarean section. (b) A health benefit plan that provides to a woman who has given birth to a child and the newborn child coverage for in-home postdelivery care is not required to provide the coverage required under Subsection (a) unless: (1) the attending physician determines that inpatient care is medically necessary; or (2) the woman requests inpatient care. (c) For purposes of Subsection (a), the attending physician shall determine whether a delivery is complicated. (d) This section does not require a woman who is eligible for coverage under a health benefit plan to: (1) give birth to a child in a hospital or other health care facility; or (2) remain under inpatient care in a hospital or other health care facility for any fixed term following the birth of a child. Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.