This bulletin is directed to all insurers issuing or delivering policies of accident and sickness insurance in the state of Indiana as defined by IC 27-8-5-1 and all health maintenance organizations (HMOs) specified by IC 27-13-7-20 regarding chemotherapy medications.

This bulletin is intended to provide guidance on the implementation of IC 27-8-32 and IC 27-13-7-20 for policies issued, renewed, or delivered after December 31, 2009. The Department interprets IC 27-8-32 and IC 27-13-7-20 as applicable only to health insurance plans defined pursuant to IC 27-8-14.5-1.

Policies of accident and health, including HMO contracts, that provide coverage for both oral and intravenous/injectable chemotherapy treatment shall provide coverage for oral chemotherapy that is no less favorable in terms of dollar limits, copayments, deductibles, or coinsurance than the coverage provided pursuant to the nonpharmacy policy benefits for chemotherapy.

Questions concerning this bulletin should be addressed to Robyn S. Crosson, Chief Deputy Commissioner for Company Compliance Services, who can be reached at (317) 234-6293 or rcrosson@idoi.in.gov.

INDIANA DEPARTMENT OF INSURANCE

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Carol Cutter, Commissioner

DIN: 20091104-IR-760090866NRA

Composed: May 04,2024 4:47:29AM EDT

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