Provisions covering preexisting conditions

Any accident and sickness policy or certificate subject to the provisions of this chapter, other than credit health insurance as defined in subdivision 58-19-2(1) and a health benefit plan as defined in § 58-17-66 , shall comply with the following provisions: (1) No policy or certificate may deny, exclude, or limit benefits for a covered individual for claims incurred more than twelve months following the effective date of the person's coverage due to a preexisting condition; (2) No policy or certificate may define a preexisting condition more restrictively than: (a) A condition that would have caused an ordinarily prudent person to seek medical advice, diagnosis, care, or treatment during the twelve months immediately preceding the effective date of coverage; (b) A condition for which medical advice, diagnosis, care, or treatment was recommended or received during the twelve months immediately preceding the effective date of coverage; or (c) A pregnancy existing on the effective date of coverage. Source: SL 1997, ch 288 , § 2; SL 2001, ch 275 , § 4; SL 2013, ch 248 , § 1. 58-17-98 . Health insurance policies to provide coverage for biologically - based mental illnesses. Every policy of health insurance that is delivered, issued for delivery, or renewed in this state, except for policies that provide coverage for specified disease or other limited benefit coverage, shall provide, in writing, coverage for the treatment and diagnosis of biologically - based mental illnesses with the same dollar limits, deductibles, coinsurance factors, and restrictions as for other covered illnesses. The term, biologically - based mental illness, means schizophrenia and other psychotic disorders, bipolar disorder, major depression, and obsessive - compulsive disorder. Source: SL 1998, ch 291 , § 1; SL 1999, ch 251 , § 1.