{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/38.2-3411.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/38.2-3411.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/38.2-3411.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/38.2-3411.html"}],"law_id":76551,"edition_id":1,"section_id":76551,"structure_id":14324,"section_number":"38.2-3411","catch_line":"Coverage of newborn children required","history":"1975, c. 281, \u00a7 38.1-348.6; 1976, c. 342; 1986, c. 562; 1993, c. 263; 2013, c. 653.","full_text":"A\n\nEach individual and group accident and sickness insurance policy or individual and group subscription contract providing coverage on an expense incurred basis, and each health maintenance organization providing a health care plan for health care services that provides coverage for a family member of the insured or the subscriber shall, as to the family members’ coverage, also provide that the accident and sickness insurance benefits applicable for children shall be payable with respect to a newly born child of the insured or subscriber from the moment of birth.B\n\nCoverage for newly born children shall be identical to coverage provided to the insured or subscriber except that, regardless of whether such coverage would otherwise be provided under the terms and conditions of the insurance policy, subscription contract, or health care plan, coverage shall be provided for:1\n\nNecessary care and treatment of medically diagnosed congenital defects and birth abnormalities, with coverage limits no more restrictive than for any injury or sickness covered under the insurance policy, subscription contract, or health care plan; and2\n\nInpatient and outpatient dental, oral surgical, and orthodontic services that are medically necessary for the treatment of medically diagnosed cleft lip, cleft palate or ectodermal dysplasia. Such coverage shall be subject to any deductible, cost-sharing, and policy, contract, or health care plan maximum provisions, provided they are no more restrictive for such services than for any injury or sickness covered under the insurance policy, subscription contract, or health care plan.C\n\nIf payment of a specific premium or subscription fee is required to provide coverage for a child, the policy, subscription contract, or health care plan may require that notification of birth of a newly born child and payment of the required premium or fees shall be furnished to the insurer issuing the policy or health care plan or corporation issuing the subscription contract within 31 days after the date of birth in order to have the coverage continue beyond the 31-day period.","order_by":null,"text":{"0":{"id":274802,"text":"Each individual and group accident and sickness insurance policy or individual and group subscription contract providing coverage on an expense incurred basis, and each health maintenance organization providing a health care plan for health care services that provides coverage for a family member of the insured or the subscriber shall, as to the family members’ coverage, also provide that the accident and sickness insurance benefits applicable for children shall be payable with respect to a newly born child of the insured or subscriber from the moment of birth.","type":"section","prefixes":["A"],"prefix":"A","entire_prefix":"A","prefix_anchor":"A","level":1,"next_prefix":"B"},"1":{"id":274803,"text":"Coverage for newly born children shall be identical to coverage provided to the insured or subscriber except that, regardless of whether such coverage would otherwise be provided under the terms and conditions of the insurance policy, subscription contract, or health care plan, coverage shall be provided for:","type":"section","prefixes":["B"],"prefix":"B","entire_prefix":"B","prefix_anchor":"B","level":1,"prior_prefix":"A","next_prefix":"B1"},"2":{"id":274804,"text":"Necessary care and treatment of medically diagnosed congenital defects and birth abnormalities, with coverage limits no more restrictive than for any injury or sickness covered under the insurance policy, subscription contract, or health care plan; and","type":"section","prefixes":["B","1"],"prefix":"1","entire_prefix":"B1","prefix_anchor":"B1","level":2,"prior_prefix":"B","next_prefix":"B2"},"3":{"id":274805,"text":"Inpatient and outpatient dental, oral surgical, and orthodontic services that are medically necessary for the treatment of medically diagnosed cleft lip, cleft palate or ectodermal dysplasia. Such coverage shall be subject to any deductible, cost-sharing, and policy, contract, or health care plan maximum provisions, provided they are no more restrictive for such services than for any injury or sickness covered under the insurance policy, subscription contract, or health care plan.","type":"section","prefixes":["B","2"],"prefix":"2","entire_prefix":"B2","prefix_anchor":"B2","level":2,"prior_prefix":"B1","next_prefix":"C"},"4":{"id":274806,"text":"If payment of a specific premium or subscription fee is required to provide coverage for a child, the policy, subscription contract, or health care plan may require that notification of birth of a newly born child and payment of the required premium or fees shall be furnished to the insurer issuing the policy or health care plan or corporation issuing the subscription contract within 31 days after the date of birth in order to have the coverage continue beyond the 31-day period.","type":"section","prefixes":["C"],"prefix":"C","entire_prefix":"C","prefix_anchor":"C","level":1,"prior_prefix":"B2"}},"ancestry":[{"id":14324,"edition_id":1,"name":"Mandated Benefits","identifier":"2","label":"article","depth":3,"order_by":1,"parent_id":12993,"metadata":{},"date_created":"2026-06-26 03:47:45","date_modified":"2026-06-26 03:47:45","permalink":{"id":215143,"object_type":"structure","relational_id":14324,"identifier":"2","token":"38.2\/34\/2","url":"\/38.2\/34\/2\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12993,"edition_id":1,"name":"Provisions Relating to Accident and Sickness Insurance","identifier":"34","label":"chapter","depth":2,"order_by":1,"parent_id":12698,"metadata":{},"date_created":"2026-06-26 03:44:07","date_modified":"2026-06-26 03:44:07","permalink":{"id":214887,"object_type":"structure","relational_id":12993,"identifier":"34","token":"38.2\/34","url":"\/38.2\/34\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12698,"edition_id":1,"name":"Insurance","identifier":"38.2","label":"title","depth":1,"order_by":1,"parent_id":null,"metadata":{},"date_created":"2026-06-26 03:43:49","date_modified":"2026-06-26 03:43:49","permalink":{"id":210661,"object_type":"structure","relational_id":12698,"identifier":"38.2","token":"38.2","url":"\/38.2\/","edition_id":1,"permalink":0,"preferred":1}}],"structure_contents":[{"id":87046,"structure_id":14324,"section_number":"38.2-3408","catch_line":"Policy providing for reimbursement for services that may be performed by certain practitioners other than physicians","url":"\/38.2-3408\/","token":"38.2\/34\/2\/38.2-3408","metadata":false},{"id":55621,"structure_id":14324,"section_number":"38.2-3409","catch_line":"Coverage of dependent children","url":"\/38.2-3409\/","token":"38.2\/34\/2\/38.2-3409","metadata":false},{"id":68501,"structure_id":14324,"section_number":"38.2-3410","catch_line":"Construction of policy generally; words \"physician\" and \"doctor\" to include dentist","url":"\/38.2-3410\/","token":"38.2\/34\/2\/38.2-3410","metadata":false},{"id":76551,"structure_id":14324,"section_number":"38.2-3411","catch_line":"Coverage of newborn children required","url":"\/38.2-3411\/","token":"38.2\/34\/2\/38.2-3411","metadata":false},{"id":71629,"structure_id":14324,"section_number":"38.2-3411.1","catch_line":"Coverage for child health supervision services","url":"\/38.2-3411.1\/","token":"38.2\/34\/2\/38.2-3411.1","metadata":false},{"id":70694,"structure_id":14324,"section_number":"38.2-3411.2","catch_line":"Coverage of adopted children required","url":"\/38.2-3411.2\/","token":"38.2\/34\/2\/38.2-3411.2","metadata":false},{"id":77817,"structure_id":14324,"section_number":"38.2-3411.3","catch_line":"Coverage for childhood immunizations","url":"\/38.2-3411.3\/","token":"38.2\/34\/2\/38.2-3411.3","metadata":false},{"id":86598,"structure_id":14324,"section_number":"38.2-3411.4","catch_line":"Coverage for infant hearing screening and related diagnostics","url":"\/38.2-3411.4\/","token":"38.2\/34\/2\/38.2-3411.4","metadata":false},{"id":63024,"structure_id":14324,"section_number":"38.2-3412","catch_line":"Repealed","url":"\/38.2-3412\/","token":"38.2\/34\/2\/38.2-3412","metadata":false},{"id":84153,"structure_id":14324,"section_number":"38.2-3412.1","catch_line":"Coverage for mental health and substance use 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prohibited","url":"\/38.2-3415\/","token":"38.2\/34\/2\/38.2-3415","metadata":false},{"id":69898,"structure_id":14324,"section_number":"38.2-3416","catch_line":"Repealed","url":"\/38.2-3416\/","token":"38.2\/34\/2\/38.2-3416","metadata":false},{"id":59007,"structure_id":14324,"section_number":"38.2-3417","catch_line":"Deductibles and coinsurance options required","url":"\/38.2-3417\/","token":"38.2\/34\/2\/38.2-3417","metadata":false},{"id":81514,"structure_id":14324,"section_number":"38.2-3418","catch_line":"Coverage for victims of rape or incest","url":"\/38.2-3418\/","token":"38.2\/34\/2\/38.2-3418","metadata":false},{"id":85746,"structure_id":14324,"section_number":"38.2-3418.1","catch_line":"Coverage for mammograms","url":"\/38.2-3418.1\/","token":"38.2\/34\/2\/38.2-3418.1","metadata":false},{"id":86304,"structure_id":14324,"section_number":"38.2-3418.10","catch_line":"Coverage for diabetes","url":"\/38.2-3418.10\/","token":"38.2\/34\/2\/38.2-3418.10","metadata":false},{"id":87414,"structure_id":14324,"section_number":"38.2-3418.11","catch_line":"Coverage for hospice care","url":"\/38.2-3418.11\/","token":"38.2\/34\/2\/38.2-3418.11","metadata":false},{"id":81464,"structure_id":14324,"section_number":"38.2-3418.12","catch_line":"Coverage for hospitalization and anesthesia for dental procedures","url":"\/38.2-3418.12\/","token":"38.2\/34\/2\/38.2-3418.12","metadata":false},{"id":82972,"structure_id":14324,"section_number":"38.2-3418.13","catch_line":"Coverage for the treatment of morbid obesity","url":"\/38.2-3418.13\/","token":"38.2\/34\/2\/38.2-3418.13","metadata":false},{"id":85731,"structure_id":14324,"section_number":"38.2-3418.14","catch_line":"Coverage for lymphedema","url":"\/38.2-3418.14\/","token":"38.2\/34\/2\/38.2-3418.14","metadata":false},{"id":71964,"structure_id":14324,"section_number":"38.2-3418.15","catch_line":"Coverage for prosthetic devices and components","url":"\/38.2-3418.15\/","token":"38.2\/34\/2\/38.2-3418.15","metadata":false},{"id":57543,"structure_id":14324,"section_number":"38.2-3418.15:1","catch_line":"Coverage for prosthetic devices and components","url":"\/38.2-3418.15_1\/","token":"38.2\/34\/2\/38.2-3418.15_1","metadata":false},{"id":61286,"structure_id":14324,"section_number":"38.2-3418.16","catch_line":"Coverage for telemedicine services","url":"\/38.2-3418.16\/","token":"38.2\/34\/2\/38.2-3418.16","metadata":false},{"id":81144,"structure_id":14324,"section_number":"38.2-3418.17","catch_line":"Coverage for autism spectrum disorder","url":"\/38.2-3418.17\/","token":"38.2\/34\/2\/38.2-3418.17","metadata":false},{"id":60567,"structure_id":14324,"section_number":"38.2-3418.18","catch_line":"Coverage for formula and enteral nutrition products as medicine","url":"\/38.2-3418.18\/","token":"38.2\/34\/2\/38.2-3418.18","metadata":false},{"id":79176,"structure_id":14324,"section_number":"38.2-3418.19","catch_line":"Coverage for organ, eye or tissue transplant","url":"\/38.2-3418.19\/","token":"38.2\/34\/2\/38.2-3418.19","metadata":false},{"id":69963,"structure_id":14324,"section_number":"38.2-3418.1:1","catch_line":"Repealed","url":"\/38.2-3418.1_1\/","token":"38.2\/34\/2\/38.2-3418.1_1","metadata":false},{"id":72277,"structure_id":14324,"section_number":"38.2-3418.1:2","catch_line":"Coverage for pap smears","url":"\/38.2-3418.1_2\/","token":"38.2\/34\/2\/38.2-3418.1_2","metadata":false},{"id":64216,"structure_id":14324,"section_number":"38.2-3418.1:3","catch_line":"Cost sharing for breast examinations","url":"\/38.2-3418.1_3\/","token":"38.2\/34\/2\/38.2-3418.1_3","metadata":false},{"id":80233,"structure_id":14324,"section_number":"38.2-3418.2","catch_line":"Coverage of procedures involving bones and joints","url":"\/38.2-3418.2\/","token":"38.2\/34\/2\/38.2-3418.2","metadata":false},{"id":73658,"structure_id":14324,"section_number":"38.2-3418.20","catch_line":"Coverage for hearing aids and related services [Not in effect]","url":"\/38.2-3418.20\/","token":"38.2\/34\/2\/38.2-3418.20","metadata":false},{"id":76455,"structure_id":14324,"section_number":"38.2-3418.21","catch_line":"Coverage for hearing aids and related services","url":"\/38.2-3418.21\/","token":"38.2\/34\/2\/38.2-3418.21","metadata":false},{"id":67690,"structure_id":14324,"section_number":"38.2-3418.22","catch_line":"Coverage for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute-onset neuropsychiatric syndrome","url":"\/38.2-3418.22\/","token":"38.2\/34\/2\/38.2-3418.22","metadata":false},{"id":79724,"structure_id":14324,"section_number":"38.2-3418.3","catch_line":"Coverage for hemophilia and congenital bleeding disorders","url":"\/38.2-3418.3\/","token":"38.2\/34\/2\/38.2-3418.3","metadata":false},{"id":86337,"structure_id":14324,"section_number":"38.2-3418.4","catch_line":"Coverage for reconstructive breast surgery; notice; eligibility","url":"\/38.2-3418.4\/","token":"38.2\/34\/2\/38.2-3418.4","metadata":false},{"id":87401,"structure_id":14324,"section_number":"38.2-3418.5","catch_line":"Coverage for early intervention services","url":"\/38.2-3418.5\/","token":"38.2\/34\/2\/38.2-3418.5","metadata":false},{"id":61674,"structure_id":14324,"section_number":"38.2-3418.6","catch_line":"Minimum hospital stay for mastectomy and certain lymph node dissection patients","url":"\/38.2-3418.6\/","token":"38.2\/34\/2\/38.2-3418.6","metadata":false},{"id":71759,"structure_id":14324,"section_number":"38.2-3418.7","catch_line":"Coverage for prostate cancer screening","url":"\/38.2-3418.7\/","token":"38.2\/34\/2\/38.2-3418.7","metadata":false},{"id":62197,"structure_id":14324,"section_number":"38.2-3418.7:1","catch_line":"Coverage for colorectal cancer screening","url":"\/38.2-3418.7_1\/","token":"38.2\/34\/2\/38.2-3418.7_1","metadata":false},{"id":63576,"structure_id":14324,"section_number":"38.2-3418.8","catch_line":"Coverage for clinical trials for treatment studies on cancer","url":"\/38.2-3418.8\/","token":"38.2\/34\/2\/38.2-3418.8","metadata":false},{"id":72556,"structure_id":14324,"section_number":"38.2-3418.9","catch_line":"Minimum hospital stay for hysterectomy","url":"\/38.2-3418.9\/","token":"38.2\/34\/2\/38.2-3418.9","metadata":false},{"id":66144,"structure_id":14324,"section_number":"38.2-3419","catch_line":"Additional mandated coverage made optional to group policy or contract holder","url":"\/38.2-3419\/","token":"38.2\/34\/2\/38.2-3419","metadata":false},{"id":57559,"structure_id":14324,"section_number":"38.2-3419.1","catch_line":"Report of costs and utilization of mandated benefits","url":"\/38.2-3419.1\/","token":"38.2\/34\/2\/38.2-3419.1","metadata":false}],"previous_section":{"id":68501,"structure_id":14324,"section_number":"38.2-3410","catch_line":"Construction of policy generally; words \"physician\" and \"doctor\" to include dentist","url":"\/38.2-3410\/","token":"38.2\/34\/2\/38.2-3410","metadata":false},"next_section":{"id":71629,"structure_id":14324,"section_number":"38.2-3411.1","catch_line":"Coverage for child health supervision services","url":"\/38.2-3411.1\/","token":"38.2\/34\/2\/38.2-3411.1","metadata":false},"metadata":false,"official_url":"https:\/\/law.lis.virginia.gov\/vacode\/38.2-3411\/","history_text":"

This law was first created in 1975. The record of its establishment is cataloged in chapter 281 of that year\u2019s edition of \u201cActs of Assembly,\u201d the annual state publication listing all changes made to the Code of Virginia in that year. Unfortunately, the 1975 \u201cActs\u201d aren\u2019t available online. It has been modified 4 times. Those modifications are cataloged by \u201cThe Acts of Assembly,\u201d a state publication, by year and chapter. Those modifications that can be read on the General Assembly\u2019s website will be linked accordingly. Those modifications are as follows: in 1976, chapter 342; in 1986, chapter 562; in 1993, chapter 263; in 2013, chapter 653<\/a>.<\/p>","references":[{"id":84333,"section_number":"38.2-3406.1","catch_line":"Application of requirements that policies offered by small employers include state-mandated health benefits","order_by":null,"url":"\/38.2-3406.1\/"},{"id":55347,"section_number":"38.2-4214","catch_line":"Application of certain provisions of law","order_by":null,"url":"\/38.2-4214\/"},{"id":67952,"section_number":"38.2-4319","catch_line":"Statutory construction and relationship to other laws","order_by":null,"url":"\/38.2-4319\/"}],"refers_to":false,"permalink":{"id":215157,"object_type":"law","relational_id":76551,"identifier":"38.2-3411","token":"38.2\/34\/2\/38.2-3411","url":"\/38.2-3411\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/38.2-3411\/","token":"38.2\/34\/2\/38.2-3411","dublin_core":{"Title":"Coverage of newborn children required","Type":"Text","Format":"text\/html","Identifier":"\u00a7 38.2-3411","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t

A.<\/span> Each individual and group accident and sickness insurance<\/span> policy or individual and group subscription contract<\/span> providing coverage on an expense incurred basis, and each health maintenance organization providing a health care plan for health care services that provides coverage for a family member of the insured or the subscriber shall, as to the family members’ coverage, also provide that the accident and sickness insurance<\/span> benefits applicable for children shall be payable with respect to a newly born child of the insured or subscriber from the moment of birth. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

B.<\/span> Coverage for newly born children shall be identical to coverage provided to the insured or subscriber except that, regardless of whether such coverage would otherwise be provided under the terms and conditions of the insurance<\/span> policy, subscription contract<\/span>, or health care plan, coverage shall be provided for: <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

1.<\/span> Necessary care and treatment of medically diagnosed congenital defects and birth abnormalities, with coverage limits no more restrictive than for any injury or sickness covered under the insurance<\/span> policy, subscription contract<\/span>, or health care plan; and <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

2.<\/span> Inpatient and outpatient dental, oral surgical, and orthodontic services that are medically necessary for the treatment of medically diagnosed cleft lip, cleft palate or ectodermal dysplasia. Such coverage shall be subject to any deductible, cost-sharing, and policy, contract<\/span>, or health care plan maximum provisions, provided they are no more restrictive for such services than for any injury or sickness covered under the insurance<\/span> policy, subscription contract<\/span>, or health care plan. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

C.<\/span> If payment of a specific premium or subscription fee is required to provide coverage for a child, the policy, subscription contract<\/span>, or health care plan may require that notification of birth of a newly born child and payment of the required premium or fees shall be furnished to the insurer<\/span> issuing the policy or health care plan or corporation issuing the subscription contract<\/span> within 31 days after the date of birth in order<\/span> to have the coverage continue beyond the 31-day period. <\/i><\/a><\/p><\/section>","plain_text":" CODE OF VIRGINIA\n\nCOVERAGE OF NEWBORN CHILDREN REQUIRED (\u00a7 38.2-3411)\n\nA. Each individual and group accident and sickness insurance policy or\nindividual and group subscription contract providing coverage on an expense\nincurred basis, and each health maintenance organization providing a health care\nplan for health care services that provides coverage for a family member of the\ninsured or the subscriber shall, as to the family members’ coverage, also\nprovide that the accident and sickness insurance benefits applicable for\nchildren shall be payable with respect to a newly born child of the insured or\nsubscriber from the moment of birth.\n\nB. Coverage for newly born children shall be identical to coverage provided to\nthe insured or subscriber except that, regardless of whether such coverage would\notherwise be provided under the terms and conditions of the insurance policy,\nsubscription contract, or health care plan, coverage shall be provided for:\n\n 1. Necessary care and treatment of medically diagnosed congenital defects and\n birth abnormalities, with coverage limits no more restrictive than for any\n injury or sickness covered under the insurance policy, subscription contract,\n or health care plan; and\n\n 2. Inpatient and outpatient dental, oral surgical, and orthodontic services\n that are medically necessary for the treatment of medically diagnosed cleft\n lip, cleft palate or ectodermal dysplasia. Such coverage shall be subject to\n any deductible, cost-sharing, and policy, contract, or health care plan\n maximum provisions, provided they are no more restrictive for such services\n than for any injury or sickness covered under the insurance policy,\n subscription contract, or health care plan.\n\nC. If payment of a specific premium or subscription fee is required to provide\ncoverage for a child, the policy, subscription contract, or health care plan may\nrequire that notification of birth of a newly born child and payment of the\nrequired premium or fees shall be furnished to the insurer issuing the policy or\nhealth care plan or corporation issuing the subscription contract within 31 days\nafter the date of birth in order to have the coverage continue beyond the 31-day\nperiod.\n\nHISTORY: 1975, c. 281, \u00a7 38.1-348.6; 1976, c. 342; 1986, c. 562; 1993, c. 263;\n2013, c. 653.","edition":{"id":1,"name":"2025","slug":"2025","date_created":"2026-06-21 22:39:22","date_modified":"2026-06-21 22:39:22","current":1,"order_by":1,"last_import":null}}