§ 500.3515

500.3515 Additional health services; deductibles; copayments; 'preventive health care services' defined; partial payment from government or private person.Sec. 3515. (1) A health maintenance organization may provide additional health services or any other related health care service or treatment not required under this act. (2) A health maintenance organization may have health maintenance contracts with deductibles. A health maintenance organization may have health maintenance contracts that include copayments, stated as dollar amounts for the cost of covered services, and coinsurance, stated as percentages for the cost of covered services. This subsection does not limit the director's authority to regulate and establish fair, sound, and reasonable copayment and coinsurance limits including out of pocket maximums. (3) A health maintenance organization shall not require that contributions be made to a deductible for preventive health care services. As used in this subsection, 'preventive health care services' means services designated to maintain an individual in optimum health and to prevent unnecessary injury, illness, or disability.

ervices. As used in this subsection, 'preventive health care services' means services designated to maintain an individual in optimum health and to prevent unnecessary injury, illness, or disability. (4) A health maintenance organization may accept from governmental agencies and from private persons payments covering any part of the cost of health maintenance contracts. History: Add. 2000, Act 252, Imd. Eff. June 29, 2000 ;-- Am. 2002, Act 304, Imd. Eff. May 10, 2002 ;-- Am. 2002, Act 621, Imd. Eff. Dec. 23, 2002 ;-- Am. 2005, Act 306, Imd. Eff. Dec. 21, 2005 ;-- Am. 2016, Act 97, Eff. Aug. 1, 2016 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016 Popular Name: Act 218Popular Name: HMO