| | | (3) If benefits and coverage for the treatment of | | physical illness are provided on an expense-incurred | | basis, the benefits and coverage required under this | | subsection may be delivered separately under a | | managed care system. |
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| | | (4)__A policy or contract may not have separate | | maximums for physical illness and mental illness, | | separate deductibles and coinsurance amounts for | | physical illness and mental illness, separate out-of- | | pocket limits in a benefit period of not more than 12 | | months for physical illness and mental illness or | | separate office visitation limits for physical | | illness and mental illness. |
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| | | (5)__A health benefit plan may not impose a | | limitation on coverage or benefits for mental illness | | unless that same limitation is also imposed on the | | coverage and benefits for physical illness covered | | under the policy or contract. |
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| | | (6)__Copayments required under a policy or contract | | for benefits and coverage for mental illness must be | | actuarially equivalent to any coinsurance | | requirements or, if there are no coinsurance | | requirements, not greater than any copayment required | | under the policy or contract for a benefit or | | coverage for a physical illness. |
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| | | (7)__For the purposes of this section, medication | | management visits associated with a mental illness | | must be covered in the same manner as a medication | | management visit for the treatment of a physical | | illness and may not be counted in the calculation of | | any maximum outpatient treatment visit limits. |
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| | | This subsection does not apply to policies, contracts or | | certificates covering employees of employers with 20 or fewer | | employees, whether the group policy is issued to the employer, | | to an association, to a multiple-employer trust or to another | | entity. |
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| | This subsection may not be construed to allow coverage and | benefits for the treatment of alcoholism and other drug | dependencies through the diagnosis of a mental illness listed | in paragraph A. |
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| | | Sec. 21. 24-A MRSA §4234-A, sub-§7, as amended by PL 1995, c. 637, | | §7, is further amended to read: |
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