| (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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