Section 38a-511 - [Effective 1/1/2025] Copayments re in-network imaging services(a) No health insurer, health care center, hospital service corporation, medical service corporation or fraternal benefit society that provides coverage under an individual health insurance policy or contract for magnetic resonance imaging or computed axial tomography may (1) require total copayments in excess of three hundred seventy-five dollars for all such in-network imaging services combined annually, or (2) require a copayment in excess of seventy-five dollars for each in-network magnetic resonance imaging or computed axial tomography, provided the physician ordering the radiological services and the physician rendering such services are not the same person or are not participating in the same group practice.(b) No health insurer, health care center, hospital service corporation, medical service corporation or fraternal benefit society that provides coverage under an individual health insurance policy or contract for positron emission tomography may (1) require total copayments in excess of four hundred dollars for all such in-network imaging services combined annually, or (2) require a copayment in excess of one hundred dollars for each in-network positron emission tomography, provided the physician ordering the radiological service and the physician rendering such service are not the same person or are not participating in the same group practice.(c) The provisions of subsections (a) and (b) of this section shall not apply to a high deductible health plan as that term is used in subsection (f) of section 38a-493 and a copayment-only health plan. For purposes of this section, "copayment-only health plan" means a health plan that imposes a specific dollar amount to be paid by the insured for a health care service or prescription drug paid for or reimbursed by such health plan. "Copayment-only health plan" does not include deductibles or coinsurance.Conn. Gen. Stat. § 38a-511
( P.A. 06-180 , S. 1 ; 07-54 , S. 3 ; P.A. 10-5 , S. 25 ; P.A. 18-68 , S. 14 .)
Amended by P.A. 24-0081,S. 101 of the Connecticut Acts of the 2024 Regular Session, eff. 1/1/2025.Amended by P.A. 20-0004, S. 25 of the 2020 July Special Session, eff. 10/1/2020.Amended by P.A. 18-0068, S. 14 of the Connecticut Acts of the 2018 Regular Session, eff. 10/1/2018.Amended by P.A. 10-0005, S. 25 of the February 2010 Regular Session, eff. 5/5/2010.This section is set out more than once due to postponed, multiple, or conflicting amendments. See Sec. 38a-550 for similar provisions re group policies.