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IC 27-8-14.5-1
"Health insurance plan" defined
Sec. 1. (a) As used in this chapter, "health insurance plan" means
any:
(1) hospital or medical expense incurred policy or certificate;
(2) hospital or medical service plan contract; or
(3) health maintenance organization subscriber contract;
provided to an insured.
(b) The term does not include the following:
(1) Accident only, credit, dental, vision, Medicare supplement,
long term care, or disability income insurance.
(2) Coverage issued as a supplement to liability insurance.
(3) Worker's compensation or similar insurance.
(4) Automobile medical payment insurance.
(5) A specified disease policy.
(6) A short term insurance plan that:
(A) may not be renewed; and
(B) has a duration of not more than six (6) months.
(7) A policy that provides indemnity benefits not based on any
expense incurred requirement, including a plan that provides
coverage for:
(A) hospital confinement, critical illness, or intensive care;
or
(B) gaps for deductibles or copayments.
(8) A supplemental plan that always pays in addition to other
coverage.
(9) A student health plan.
(10) An employer sponsored health benefit plan that is:
(A) provided to individuals who are eligible for Medicare;
and
(B) not marketed as, or held out to be, a Medicare
supplement policy.
As added by P.L.190-1997, SEC.1. Amended by P.L.173-2007,
SEC.33.
IC 27-8-14.5-2
"Insured" defined
Sec. 2. As used in this chapter, "insured" refers to an individual
with:
(1) insulin-using diabetes;
(2) non-insulin using diabetes; or
(3) elevated blood glucose levels induced by pregnancy or
another medical condition;
who is covered by a health insurance plan issued by an insurer.
As added by P.L.190-1997, SEC.1.
IC 27-8-14.5-4
Coverage for treatments, supplies, and equipment
Sec. 4. A health insurance plan issued by an insurer must provide
coverage to the insured for the medically necessary treatment for
diabetes, including medically necessary supplies and equipment as
ordered in writing by a physician licensed under IC 25-22.5 or a
podiatrist licensed under IC 25-29, subject to the general provisions
of the health insurance plan.
As added by P.L.190-1997, SEC.1.
IC 27-8-14.5-5
Deductible, copayment, and coinsurance provisions
Sec. 5. (a) An insured may not be required to pay an annual
deductible or copayment that is greater than an annual deductible or
copayment established for similar benefits under the health insurance
plan. If the plan does not cover a similar benefit, the copayment or
deductible may not be set at a level that materially diminishes the
value of the diabetes benefit required by this chapter.
(b) An insured may be subject to coinsurance that is not greater
than coinsurance established for similar benefits under the health
insurance plan. If the plan does not cover a similar benefit, the
coinsurance may not be set at a level that materially diminishes the
value of the diabetes benefit required by this chapter.
As added by P.L.190-1997, SEC.1.
IC 27-8-14.5-6
Coverage for diabetes self-management training
Sec. 6. (a) A health insurance plan issued by an insurer must
provide coverage for diabetes self-management training that is:
(1) medically necessary;
(2) ordered in writing by a physician licensed under IC 25-22.5
or a podiatrist licensed under IC 25-29; and
(3) provided by a health care professional who:
(A) is licensed, registered, or certified under IC 25; and
(B) has specialized training in the management of diabetes.
(b) Coverage for diabetes self-management training may be
limited to the following:
IC 27-8-14.5-7
Adoption of rules
Sec. 7. The department may adopt rules under IC 4-22-2 to carry
out this chapter.
As added by P.L.190-1997, SEC.1.