(1) An insurer must provide medically necessary benefits including inpatient and outpatient hospital, physician, advanced practice registered nursing, prescription drugs, laboratory and radiology, mental health, chemical dependency, vision, audiology and medical dental benefits as provided in this subchapter unless specific limitations to benefit coverage are noted.

(2) Eyeglasses and dental benefits are paid by the department as specified in ARM 37.79.322 and 37.79.326.

(3) Emergency services, including urgent care and emergency room screening to determine if a medical emergency exists, shall be available 24 hours per day, seven days per week. In emergency situations, no pre-authorization is required to provide necessary medical care and enrollees may seek care from nonparticipating providers. The insurer may, however, require prior authorization for any needed follow-up care.