South Carolina H 3586: Health insurance coverage

Bill Text

2025-2026 Bill 3586 Text of Previous Version (Dec. 12, 2024) - South Carolina Legislature Online 

South Carolina General Assembly
126th Session, 2025-2026

Bill 3586

Indicates Matter Stricken
Indicates New Matter

(Text matches printed bills. Document has been reformatted to meet World Wide Web specifications.)

A bill

TO AMEND THE SOUTH CAROLINA CODE OF LAWS BY ADDING SECTION 
38-71-660 SO AS TO REQUIRE ISSUERS OF INDIVIDUAL HEALTH INSURANCE COVERAGE IN 
THIS STATE TO ISSUE INDIVIDUAL HEALTH INSURANCE COVERAGE FOR MINOR CHILDREN REGARDLESS 
OF WHETHER THE CHILD IS A DEPENDENT OF AN INSURED OF THE ISSUER; AND TO AMEND 
SECTION 38-71-145, RELATING TO REQUIRED COVERAGE IN INDIVIDUAL AND GROUP HEALTH 
INSURANCE POLICIES AND HEALTH MAINTENANCE ORGANIZATION POLICES, SO AS TO 
REQUIRE COVERAGE FOR MATERNITY CARE, AND TO DEFINE "MATERNITY CARE."

Be it enacted by the 
General Assembly of the State of South Carolina:

SECTION 1. SubArticle 7, Article 3, Chapter 71, Title 38 of the 
S.C. Code is amended by adding:

 Section 
38-71-660. Notwithstanding another provision of law, an issuer of individual 
health insurance coverage in this State shall offer this coverage to a minor 
child regardless of whether the child is a dependent of an insured of the 
issuer.

SECTION 2. Section 38-71-145 of the S.C. Code is amended to read:

 Section 
38-71-145. (A) All individual andhealth insurance policies, 
group health insurance policies, and health 
maintenance organization policies in this State shallmust include coverage in the policy 
for:

 (1) 
mammograms;

 (2) 
annual pap smears;

 (3) 
prostate cancer examinations, screenings, and laboratory work for diagnostic 
purposes in accordance with the most recent published guidelines of the 
American Cancer Society;.

 (4) maternity care. For the purposes 
of this section, "maternity care coverage" includes:

 (a) prenatal care, which must include 
coverage for regular healthcare visits and childbirth education in addition to 
ongoing assessment of nutritional and other individual needs consistent with nationally 
recognized standards and guidelines such as those promulgated by the Institute 
for Clinical Systems Improvement (ICSI) or the American College of 
Obstetricians and Gynecologists (ACOG), except when in conflict with another 
provision of this chapter;

 (b) childbirth and postdelivery care 
including minimum coverage for delivery and postdelivery care for a mother and 
her newborn in compliance with the provisions of Sections 38-71-135 and 38-7-140; 
and

 (c) postpartum care, which shall be 
provided consistent with nationally recognized standards and guidelines, such 
as those promulgated by ACOG or AAP, except when in conflict with another 
provision of this chapter.

 (B) 
The coverage required to be offered under subsection (A) may not contain any 
exclusions, reductions, or other limitations as to coverages, deductibles, or 
coinsurance provisions which apply to that coverage unless these provisions 
apply generally to other similar benefits provided and paid for under the 
health insurance policy.

 (C) 
Nothing in this section prohibits a health insurance policy from providing 
benefits greater than those required to be offered by subsections (A) and (B) 
or more favorable to the enrollee than those required to be offered by 
subsections (A) and (B).

 (D) 
This section applies to individual and group health insurance policies issued 
by a fraternal benefit society, an insurer, a health maintenance organization, 
or any similar entity, except as exempted by ERISA.

 (E) 
For purposes of this section:

 (1) 
"Mammogram" means a radiological examination of the breast for purposes of 
detecting breast cancer when performed as a result of a physician referral or 
by a health testing service which utilizes radiological equipment approved by 
the Department of Health and Environmental Control, which examination may be 
made with the following minimum frequency:

 (a) 
once as a base-line mammogram for a female who is at least thirty-five years of 
age but less than forty years of age;

 (b) 
once every two years for a female who is at least forty years of age but less 
than fifty years of age;

 (c) 
once a year for a female who is at least fifty years of age; or

 (d) 
in accordance with the most recent published guidelines of the American Cancer 
Society.

 (2) 
"Pap smear" means an examination of the tissues of the cervix of the uterus for 
the purpose of detecting cancer when performed upon the recommendation of a 
medical doctor, which examination may be made once a year or more often if 
recommended by a medical doctor.

 (3) 
"Health insurance policy" means a health benefit plan, contract, or evidence of 
coverage providing health insurance coverage as defined in Section 38-71-670(6) 
and Section 38-71-840(14).

SECTION 3. This act takes effect upon approval 
by the Governor.

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This web page was last updated on December 12, 2024 at 04:42 PM