A health insurance policy providing coverage for hospital or medical expenses, other than limited benefit coverage, shall provide, at the request of the applicant, coverage for expenses arising from treatment for alcoholism. The following conditions apply to the requirement for such coverage:

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(1) The applicant shall be informed of the applicant’s option to request this coverage.

(2) The inclusion of the coverage may be made subject to the insurer’s usual underwriting requirements.

(3) The coverage may be made subject to provisions of the policy that apply to other benefits under the policy, including but not limited to provisions relating to deductibles and coinsurance.

(4) The policy may limit hospital expense coverage to treatment provided by the following facilities:

(a) A health care facility licensed as required by ORS § 441.015.

(b) A health care facility accredited by the Joint Commission.

(5) Except as permitted by subsection (3) of this section, the policy may not limit payments thereunder for alcoholism to an amount less than $4,500 in any 24-consecutive month period and the policy shall provide coverage, within the limits of this subsection, of not less than 80 percent of the hospital and medical expenses for treatment for alcoholism. [Formerly 743.412; 2016 c.11 § 6; 2017 c.17 § 56]

See 743.402.

[Formerly 743.480; 2017 c.21 § 73; repealed by 2017 c.206 § 16]