Indiana § 5-10-8-14.8 - Employee health plan providing coverage for prescription eye drops

§ 5-10-8-14.8. Employee health plan providing coverage for prescription eye drops

Sec. 14.8. (a) This section applies to an employee health plan that provides coverage for prescription eye drops.

(b) As used in this section, "covered individual" means an individual who is entitled to coverage under a state employee health plan.

(c) As used in this section, "state employee health plan" means one (1) of the following:

(1) A self-insurance program established under section 7(b) of this chapter to provide group health coverage.

(2) A contract with a prepaid health care delivery plan that is entered into or renewed under section 7(c) of this chapter.

(d) A state employee health plan must provide coverage for a refill of prescription eye drops if the following are met:

(1) For a thirty (30) day supply, the covered individual requests the refill not earlier than twenty-five (25) days after the date the prescription eye drops were last dispensed to the covered individual.

(2) For a ninety (90) day supply, the covered individual requests the refill not earlier than seventy-five (75) days after the date the prescription eye drops were last dispensed to the covered individual.

(3) The prescribing practitioner has indicated on the prescription that the prescription eye drops are refillable and the refill requested by the covered individual does not exceed the refillable amount remaining on the prescription.

(e) The coverage required by subsection (d) must not be subject to dollar limits, copayments, deductibles, or coinsurance provisions that are less favorable to a covered individual than the dollar limits, copayments, deductibles, or coinsurance provisions that apply to coverage for prescription drugs generally under the state employee health plan.

(f) This section applies to a state employee health plan issued, delivered, amended, or renewed after December 31, 2015.

As added by P.L.43-2015, SEC.1.