Texas Insurance Code 1357.004 – Coverage Required
(a) A health benefit plan that provides coverage for mastectomy must provide coverage for:
(1) reconstruction of the breast on which the mastectomy has been performed;
(2) surgery and reconstruction of the other breast to achieve a symmetrical appearance; and
(3) prostheses and treatment of physical complications, including lymphedemas, at all stages of mastectomy.
(b) Coverage required under this section:
(1) shall be provided in a manner determined to be appropriate in consultation with the attending physician and the enrollee;
(2) may be subject to annual deductibles, copayments, and coinsurance that are consistent with annual deductibles, copayments, and coinsurance required for other coverage under the health benefit plan; and
(3) may not be subject to dollar limits other than the lifetime maximum benefits under the plan.