HB 5431 Summary

• Requires insurers delivering or renewing health insurance policies in Michigan to provide coverage for ten essential categories of services including ambulatory care, emergency services, hospitalization, and pregnancy/maternity care.

• Mandates coverage of mental health and substance use disorder services, prescription drugs, rehabilitative services, and laboratory services.

• Requires coverage of preventive and wellness services including evidence-based items rated "A" or "B" by the U.S. Preventive Services Task Force, CDC-recommended immunizations, and pediatric services including dental and vision care.

• Specifies that all mandated benefits are subject to existing requirements applicable to those benefits under the insurance code chapter.

• Does not limit insurers from providing additional benefits beyond these minimum requirements.