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<law><site_title>Virginia Decoded</site_title><site_url>https://vacode.org</site_url><law_id>76551</law_id><section_number>38.2-3411</section_number><catch_line>Coverage of newborn children required</catch_line><edition url="https://vacode.org/2025/" slug="2025" current="TRUE" last_updated="">2025</edition><referred_to_by><reference>38.2-3406.1</reference><reference>38.2-4214</reference><reference>38.2-4319</reference></referred_to_by><structure><unit label="title" level="1" order_by="1" identifier="38.2">Insurance</unit><unit label="chapter" level="2" order_by="1" identifier="34">Provisions Relating to Accident and Sickness Insurance</unit><unit label="article" level="3" order_by="1" identifier="2">Mandated Benefits</unit></structure><text>
						<section id="A"><p><span class="prefix-number">A.</span> Each individual and group accident and sickness <span class="dictionary">insurance</span> policy or individual and group subscription <span class="dictionary">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&#x2019; coverage, also provide that the accident and sickness <span class="dictionary">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. <a id="paragraph-274802" class="section-permalink" href="https://vacode.org/38.2-3411/#A"><i class="fa fa-link"/></a></p></section>
						<section id="B"><p><span class="prefix-number">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 <span class="dictionary">insurance</span> policy, subscription <span class="dictionary">contract</span>, or health care plan, coverage shall be provided for: <a id="paragraph-274803" class="section-permalink" href="https://vacode.org/38.2-3411/#B"><i class="fa fa-link"/></a></p></section>
						<section id="B1" class="indent-1"><p><span class="prefix-number">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 <span class="dictionary">insurance</span> policy, subscription <span class="dictionary">contract</span>, or health care plan; and <a id="paragraph-274804" class="section-permalink" href="https://vacode.org/38.2-3411/#B1"><i class="fa fa-link"/></a></p></section>
						<section id="B2" class="indent-1"><p><span class="prefix-number">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, <span class="dictionary">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 <span class="dictionary">insurance</span> policy, subscription <span class="dictionary">contract</span>, or health care plan. <a id="paragraph-274805" class="section-permalink" href="https://vacode.org/38.2-3411/#B2"><i class="fa fa-link"/></a></p></section>
						<section id="C"><p><span class="prefix-number">C.</span> If payment of a specific premium or subscription fee is required to provide coverage for a child, the policy, subscription <span class="dictionary">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 <span class="dictionary">insurer</span> issuing the policy or health care plan or corporation issuing the subscription <span class="dictionary">contract</span> within 31 days after the date of birth in <span class="dictionary">order</span> to have the coverage continue beyond the 31-day period. <a id="paragraph-274806" class="section-permalink" href="https://vacode.org/38.2-3411/#C"><i class="fa fa-link"/></a></p></section></text><history>1975, c. 281, &#xA7; 38.1-348.6; 1976, c. 342; 1986, c. 562; 1993, c. 263; 2013, c. 653.</history><metadata></metadata></law>
