(a) Except for a fraternal benefit society, a health care insurer that offers, issues for delivery, delivers, or renews in this state a health care insurance plan shall provide coverage under the plan for the formulas necessary for the treatment of phenylketonuria. This subsection does not apply to a health care insurance plan that the director has determined by order should be excluded from this subsection.
(b) A health care insurer providing coverage under this section may impose reasonable contract limitations but may not refuse coverage based on a preexisting condition of phenylketonuria or require that an individual covered under the plan pay a higher deductible or copayment for the cost of treating phenylketonuria than for the cost of treating another condition or illness.
(c) In this section, “cost” means the lowest of the following:
(1) the actual charge for the treatment received for phenylketonuria;
(2) the usual, customary, and reasonable charge for the treatment as determined by the contract of coverage; or
(3) the charge agreed to by contract between the treatment provider and the health care insurer.
Structure Alaska Statutes
Chapter 42. The Insurance Contract
Article 2. Specific Coverage Provisions.
Sec. 21.42.345. Required provision for coverage of dependents.
Sec. 21.42.347. Coverage for costs of birth.
Sec. 21.42.349. Coverage for newborn and infant hearing screening.
Sec. 21.42.351. Coverage for well-baby exams.
Sec. 21.42.353. Coverage for the costs of acupuncture treatment.
Sec. 21.42.355. Coverage for cost of services provided by certified nurse midwives.
Sec. 21.42.363. Eye care under health insurance.
Sec. 21.42.365. Coverage for treatment of alcoholism or drug abuse.
Sec. 21.42.375. Coverage for mammograms.
Sec. 21.42.377. Coverage for colorectal cancer screening.
Sec. 21.42.380. Coverage for treatment of phenylketonuria.
Sec. 21.42.385. Dental, vision, and hearing coverage.
Sec. 21.42.390. Coverage for treatment of diabetes.
Sec. 21.42.392. Requirements relating to dental care coverage provisions.
Sec. 21.42.395. Coverage for prostate and cervical cancer detection.
Sec. 21.42.397. Coverage for autism spectrum disorders.
Sec. 21.42.400. Coverage for reconstructive surgery following mastectomy.
Sec. 21.42.405. High deductible health plan.
Sec. 21.42.410. Coverage of dependent students on medically necessary leaves of absence.
Sec. 21.42.415. Coverage for clinical trials related to cancer.
Sec. 21.42.420. Coverage for prescription drugs; specialty drug tiers prohibited.
Sec. 21.42.422. Coverage for telehealth.
Sec. 21.42.425. Coverage for prescription topical eye medication.
Sec. 21.42.430. Coverage for anti-cancer medication.
Sec. 21.42.440. Coverage for costs of services provided by pharmacists.