Sec. 5. A policy of accident and sickness insurance must provide coverage for orthotic devices and prosthetic devices, including repairs or replacements, that:
(1) are provided or performed by a person that is:
(A) accredited as required under 42 U.S.C. 1395m(a)(20); or
(B) a qualified practitioner (as defined in 42 U.S.C. 1395m(h)(1)(F)(iii));
(2) are determined by the insured's physician to be medically necessary to restore or maintain the insured's ability to perform activities of daily living or essential job related activities; and
(3) are not solely for comfort or convenience.
As added by P.L.109-2008, SEC.2.
Structure Indiana Code
Article 8. Life, Accident, and Health
Chapter 24.2. Coverage for Prosthetic Devices
27-8-24.2-0.1. Application of Chapter
27-8-24.2-2. "Orthotic Device"
27-8-24.2-3. "Policy of Accident and Sickness Insurance"
27-8-24.2-4. "Prosthetic Device"
27-8-24.2-5. Coverage Required
27-8-24.2-6. Coverage and Reimbursement
27-8-24.2-7. Comparison to Other Benefits
27-8-24.2-8. Continued Medical Necessity Review
27-8-24.2-9. Lifetime Maximum Coverage Limitation
27-8-24.2-10. Deductible, Copayment, or Coinsurance Requirements