Indiana Code 27-2-9.1-5. Health plan procedure allowing cost of prescription drug to be counted against deductible
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Sec. 5. (a) A health plan shall implement a procedure to allow a covered individual to submit a claim to offset the covered individual’s deductible for the cost of a purchase by the covered individual of a prescription drug that:
(2) was purchased by the covered individual without submitting at the point of purchase the claim through the health plan.
(1) is covered under the covered individual’s health plan; and
Terms Used In Indiana Code 27-2-9.1-5
- covered individual: means an individual who is entitled to coverage under a health plan. See Indiana Code 27-2-9.1-1
- health plan: means a plan that is compliant with the PPACA and offered by an insurer to provide, deliver, arrange for, pay for, or reimburse the cost of health care items or services. See Indiana Code 27-2-9.1-2
(b) If a covered individual submits a claim to the health plan in accordance with the procedure established under subsection (a), the health plan shall verify the purchase described under subsection (a) and count the amount paid by the covered individual for the purchased covered prescription drug against the covered individual’s deductible.
As added by P.L.114-2020, SEC.17.