Sec. 20.1. (a) This section applies to an individual contract or a group contract that provides coverage for prescription eye drops.
(b) An individual contract or a group contract must provide coverage for a refill of prescription eye drops if the following are met:
(1) For a thirty (30) day supply, the enrollee requests the refill not earlier than twenty-five (25) days from the date the prescription eye drops were last dispensed to the enrollee.
(2) For a ninety (90) day supply, the enrollee requests the refill not earlier than seventy-five (75) days from the date the prescription eye drops were last dispensed to the enrollee.
(3) The prescribing practitioner has indicated on the prescription that the prescription eye drops are refillable and the refill requested by the enrollee does not exceed the refillable amount remaining on the prescription.
(c) The coverage required by subsection (b) must not be subject to dollar limits, copayments, deductibles, or coinsurance provisions that are less favorable to an enrollee than the dollar limits, copayments, deductibles, or coinsurance provisions that apply to coverage for prescription drugs generally under the individual contract or group contract.
(d) This section applies to an individual contract or a group contract issued, delivered, amended, or renewed after December 31, 2015.
As added by P.L.43-2015, SEC.3.
Structure Indiana Code
Article 13. Health Maintenance Organizations
Chapter 7. Requirements for Group Contracts, Individual Contracts, and Evidence of Coverage
27-13-7-0.1. Application of Certain Amendments to Chapter
27-13-7-1. Persons Entitled to Copies of Contracts
27-13-7-2. Deceptive Contract Provisions Prohibited
27-13-7-3. Contract Provisions
27-13-7-4. Compliance With Requirements; Ten Day Grace Period
27-13-7-5. Evidence of Coverage
27-13-7-6. Evidence of Coverage; Prohibited Provisions
27-13-7-7. Evidence of Coverage; Required Statement
27-13-7-7.5. Prohibition on Coverage of Abortion; Exceptions; Coverage Through Rider or Endorsement
27-13-7-8. Readability Standards
27-13-7-9. Approval of Forms by Commissioner
27-13-7-10. Coverage Outside Indiana; Commissioner's Approval Not Required
27-13-7-12. Additional Information Required by Commissioner
27-13-7-13. Continuation of Coverage Statement
27-13-7-14. Post-Mastectomy Coverage
27-13-7-14.5. Coverage for Nonexperimental, Surgical Treatment of Morbid Obesity
27-13-7-14.7. Coverage for Autism Spectrum Disorders
27-13-7-15. Dental Care Provisions Required
27-13-7-15.3. Breast Cancer Screening Mammography
27-13-7-16. Prostate Specific Antigen Test
27-13-7-17. Coverage for Colorectal Cancer Screening; Exception for Grandfathered Health Plans
27-13-7-18. Inherited Metabolic Disease Coverage
27-13-7-19. Coverage for Orthotic Devices and Prosthetic Devices
27-13-7-20. Prohibition on Chemotherapy Coverage Limitations
27-13-7-20.2. Coverage for Care Related to Cancer Clinical Trials
27-13-7-20.4. Applicability; Coverage for Methadone for Treatment of Pain
27-13-7-21. High Breast Density
27-13-7-23. Step Therapy Protocol
27-13-7-24. Coverage for Anatomical Gifts, Transplantation, or Related Health Care Services
27-13-7-24.5. Coverage for Chronic Pain Management
27-13-7-26. Coverage for Pediatric Neuropsychiatric Disorders