The bill, H.B. No. 233, amends the Texas Insurance Code to expand health benefit plan coverage for hair prostheses specifically for breast cancer patients. It introduces a new subchapter, Subchapter C, which mandates that health benefit plans provide coverage for hair prostheses for enrollees undergoing or who have undergone treatment for breast cancer, as determined appropriate by their treating physician. The bill specifies that coverage must include the repair or replacement of hair prostheses, with a minimum benefit amount of $100, and prohibits additional premiums for this coverage. However, the coverage may still be subject to standard deductibles, copayments, and coinsurance.

Additionally, the bill makes several amendments to existing sections of Chapter 1371, including the designation of subchapters and the clarification of covered benefits related to prosthetic and orthotic devices. It also ensures that the coverage for hair prostheses applies to a wide range of health benefit plans, including those issued by nonprofit organizations and state programs. The provisions of this bill will take effect on September 1, 2025, and will apply only to health benefit plans delivered or renewed on or after January 1, 2026.

Statutes affected:
Introduced: Insurance Code 1371.003, Insurance Code 1371.005 (Insurance Code 1371)