§ 695C.1691 Required provision in certain plans concerning coverage for continued medical treatment; exceptions; regulations
§ 695C.1693 Required provision concerning coverage for certain treatment received as part of clinical trial or study for treatment of cancer or chronic fatigue syndrome; authority of health maintenance organization to require certain information; immunity from
§ 695C.16932 Required provision concerning coverage for biomarker testing for diagnosis, treatment, management and monitoring of cancer in certain circumstances; establishment of process to request exception or appeal denial of coverage; time for responding to req
§ 695C.16934 Required provision concerning coverage for medically necessary treatment of conditions relating to gender dysphoria and gender incongruence; restriction on refusal to cover certain treatments; authority of health maintenance organization to prescribe
§ 695C.1694 Required provision in plan covering prescription drugs or devices concerning coverage of hormone replacement therapy in certain circumstances; prohibited acts; exception
§ 695C.16945 Plan covering prescription drugs: Required actions by health maintenance organization related to acquisition of prescription drugs for certain insureds residing in area for which emergency or disaster has been declared
§ 695C.16946 Required provision concerning coverage of recipients of Medicaid for antipsychotic or anticonvulsant medication that is not on list of preferred prescription drugs upon failure of drug on list to treat condition
§ 695C.16947 Plan covering prescription drugs: Submission to step therapy for drug to treat psychiatric condition prohibited in certain circumstances
§ 695C.1695 Required provision in plan covering outpatient care concerning coverage of health care services related to hormone replacement therapy; prohibited acts
§ 695C.1696 Required provision concerning coverage for drug or device for contraception and related health services; prohibited acts; exceptions
§ 695C.1698 Required provision concerning coverage for certain services, screenings and tests relating to wellness; prohibited acts
§ 695C.1699 Required provision concerning coverage for certain drugs and services related to substance use disorder and opioid use disorder; reimbursement of pharmacists and pharmacies for certain services; prohibited acts
§ 695C.170 Evidence of coverage: Issuance; form and contents
§ 695C.1701 Health maintenance organization required to offer and issue plan regardless of health status of persons; prohibited acts; authority to include wellness program in plan that offers discounts based on health status under certain circumstances
§ 695C.1703 Evidence of coverage covering prescription drugs: Provision of notice and information regarding use of formulary
§ 695C.1705 Group health care plan issued to replace discontinued policy or coverage: Requirements; notice of reduction of benefits; statement of benefits; applicability to self-insured employer
§ 695C.1708 Required provision concerning coverage for services provided through telehealth to same extent as though provided in person or by other means; required provision concerning reimbursement for certain services provided through telehealth in same amoun
§ 695C.1709 Required provision in group insurance policy concerning continuing coverage for enrollee on leave without pay as result of total disability
§ 695C.17095 Plan covering prescription drug for treatment of medical condition that is part of step therapy protocol: Use of certain guidelines required; establishment of process to request exemption from step therapy protocol required; granting of request; appli
§ 695C.171 Required provision in plan covering mastectomies concerning coverage relating to mastectomy; prohibited acts
§ 695C.1712 Health care plan covering maternity care: Prohibited acts by organization if enrollee is acting as gestational carrier; child deemed child of intended parent for purposes of plan
§ 695C.1713 Required provision concerning coverage of certain gynecological and obstetrical services without authorization or referral from primary care physician
§ 695C.1717 Required provision concerning coverage for autism spectrum disorders for certain persons; prohibited acts
§ 695C.172 Evidence of coverage containing exclusion, reduction or limitation of coverage relating to complications of pregnancy; prohibited acts; exception
§ 695C.1723 Required provision concerning coverage for treatment of certain inherited metabolic diseases
§ 695C.1727 Required provision in evidence of coverage covering hospital, medical or surgical expenses concerning coverage for management and treatment of diabetes
§ 695C.1728 Required provision concerning coverage for management and treatment of sickle cell disease and its variants; plan covering prescription drugs required to provide coverage for medically necessary prescription drugs to treat sickle cell disease and it
§ 695C.173 Plan covering family member of enrollee required to include certain coverage for enrollee’s newly born and adopted children and children placed with enrollee for adoption
§ 695C.1731 Required provision in plan covering treatment of colorectal cancer concerning coverage for colorectal cancer screening
§ 695C.1733 Required provision in certain evidences of coverage concerning coverage for certain drugs and related services for treatment of cancer
§ 695C.17333 Plan covering prescription drug for treatment of cancer or cancer symptom that is part of step therapy protocol: Health maintenance organization required to allow enrollee or attending practitioner to apply for exemption from step therapy protocol in
§ 695C.17335 Plan covering treatment of cancer through use of chemotherapy: Prohibited acts related to orally administered chemotherapy
§ 695C.1734 Evidence of coverage covering prescription drugs prohibited from limiting or excluding coverage for certain prescription drugs previously approved for medical condition of enrollee; exceptions
§ 695C.17345 Required provision in plan covering prescription drugs concerning coverage for prescription drugs irregularly dispensed for purpose of synchronization of chronic medications; prohibited acts; exception
§ 695C.17347 Required provision concerning coverage for screening, genetic counseling and testing related to BRCA gene in certain circumstances
§ 695C.1735 Required provision concerning coverage for certain screenings and tests for breast cancer; prohibited acts
§ 695C.1736 Required provision concerning coverage for testing, treatment and prevention of sexually transmitted diseases; required provision concerning coverage for condoms for certain insureds
§ 695C.1737 Required provision concerning coverage for examination of person who is pregnant for certain diseases
§ 695C.1743 Required provision concerning coverage for drugs, laboratory testing and certain services related to human immunodeficiency virus and hepatitis C; reimbursement of certain providers of health care for certain services; prohibited acts
§ 695C.1745 Required provision concerning coverage for certain tests and vaccines relating to human papillomavirus; prohibited acts
§ 695C.1751 Required provision in plan covering treatment of prostate cancer concerning coverage for prostate cancer screening; prohibited act
§ 695C.1755 Evidence of coverage prohibited from excluding coverage for treatment of temporomandibular joint; exception
§ 695C.1757 Plan covering prescription drugs: Denial of coverage prohibited for early refills of otherwise covered topical ophthalmic products
§ 695C.1759 Plan covering anatomical gifts, organ transplants or treatments or services related to organ transplants: Prohibited acts by health maintenance organization if insured is person with disability
§ 695C.176 Required provision concerning coverage for hospice care

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Terms Used In Nevada Revised Statutes > Chapter 695C > Coverage Generally

  • Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
  • Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. Source: OCC
  • controlled substance: means a drug, immediate precursor or other substance which is listed in schedule I, II, III, IV or V for control by the State Board of Pharmacy pursuant to Nevada Revised Statutes 0.031
  • Conviction: A judgement of guilt against a criminal defendant.
  • Dependent: A person dependent for support upon another.
  • Discovery: Lawyers' examination, before trial, of facts and documents in possession of the opponents to help the lawyers prepare for trial.
  • Enrollee: means a natural person who has been voluntarily enrolled in a health care plan. See Nevada Revised Statutes 695C.030
  • Evidence of coverage: means any certificate, agreement or contract issued to an enrollee setting forth the coverage to which the enrollee is entitled. See Nevada Revised Statutes 695C.030
  • Gift: A voluntary transfer or conveyance of property without consideration, or for less than full and adequate consideration based on fair market value.
  • Health care plan: means any arrangement whereby any person undertakes to provide, arrange for, pay for or reimburse any part of the cost of any health care services and at least part of the arrangement consists of arranging for or the provision of health care services paid for by or on behalf of the enrollee on a periodic prepaid basis. See Nevada Revised Statutes 695C.030
  • Health care services: means any services included in the furnishing to any natural person of medical or dental care or hospitalization or incident to the furnishing of such care or hospitalization, as well as the furnishing to any person of any other services for the purpose of preventing, alleviating, curing or healing human illness or injury. See Nevada Revised Statutes 695C.030
  • Health maintenance organization: means any person which provides or arranges for provision of a health care service or services and is responsible for the availability and accessibility of such service or services to its enrollees, which services are paid for or on behalf of the enrollees on a periodic prepaid basis without regard to the dates health services are rendered and without regard to the extent of services actually furnished to the enrollees, except that supplementing the fixed prepayments by nominal additional payments for services in accordance with regulations adopted by the Commissioner shall not be deemed to render the arrangement not to be on a prepaid basis. See Nevada Revised Statutes 695C.030
  • physician: means a person who engages in the practice of medicine, including osteopathy and homeopathy. See Nevada Revised Statutes 0.040
  • Provider: means any physician, hospital or other person who is licensed or otherwise authorized in this state to furnish health care services. See Nevada Revised Statutes 695C.030
  • Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.
  • Trial: A hearing that takes place when the defendant pleads "not guilty" and witnesses are required to come to court to give evidence.