Sec. 4. (a) Except as provided in subsection (b), an insurer that issues an accident and sickness insurance policy shall offer coverage for nonexperimental, surgical treatment by a health care provider of morbid obesity:
(1) that has persisted for at least five (5) years; and
(2) for which nonsurgical treatment that is supervised by a physician has been unsuccessful for at least six (6) consecutive months.
(b) An insurer that issues an accident and sickness insurance policy may not provide coverage for a surgical treatment of morbid obesity for an insured who is less than twenty-one (21) years of age unless two (2) physicians licensed under IC 25-22.5 determine that the surgery is necessary to:
(1) save the life of the insured; or
(2) restore the insured's ability to maintain a major life activity (as defined in IC 4-23-29-6);
and each physician documents in the insured's medical record the reason for the physician's determination.
As added by P.L.78-2000, SEC.2. Amended by P.L.196-2005, SEC.5; P.L.102-2006, SEC.4.
Structure Indiana Code
Article 8. Life, Accident, and Health
Chapter 14.1. Coverage for Services Related to Morbid Obesity
27-8-14.1-0.1. Application of Certain Amendments to Chapter
27-8-14.1-1. "Accident and Sickness Insurance Policy"
27-8-14.1-2. "Health Care Provider" Defined
27-8-14.1-3. "Morbid Obesity" Defined
27-8-14.1-4. Coverage for Nonexperimental, Surgical Treatment of Morbid Obesity