Kentucky Statutes 304.17A-166 – Prescription eye drops coverage to include refills and additional bottle if conditions met
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(1) As used in this section, “practitioner” has the same meaning as in KRS § 217.015.
(2) Any health benefit plan issued or renewed on or after January 1, 2015, that provides coverage for prescription eye drops shall not deny coverage for a refill of a prescription if:
(a) The refill is requested by the insured:
1. For a thirty (30) day supply, between twenty-five (25) days and thirty
(30) days from the later of:
a. The original date the prescription was distributed to the insured; or b. The date the most recent refill was distributed to the insured; and
2. For a ninety (90) day supply, between eighty (80) days and ninety (90)
days from the later of:
a. The original date the prescription was distributed to the insured; or b. The date the most recent refill was distributed to the insured; and
(b) The prescribing practitioner indicates on the original prescription that additional quantities are needed, and the refill requested by the insured does not exceed the number of additional quantities needed.
(3) (a) Any health benefit plan issued or renewed on or after January 1, 2015, that provides coverage for prescription eye drops shall provide coverage for one (1) additional bottle of prescription eye drops, pursuant to KRS § 304.17A-165, when:
1. The additional bottle is requested by the insured or the prescribing practitioner at the time the original prescription is distributed to the insured; and
2. The prescribing practitioner indicates on the original prescription that the additional bottle is needed by the insured for use in a day care center or school.
(b) Coverage for an additional bottle shall be limited to one (1) bottle every three
(3) months.
(4) The coverages required by this section shall not be subject to a greater deductible or copayment than other similar health care services provided by the health benefit plan.
Effective: January 1, 2015
History: Created 2014 Ky. Acts ch. 47, sec. 1, effective January 1, 2015.
Legislative Research Commission Note (1/1/2015). In codification, the Reviser of Statutes has altered the numbering within subsection (3) of this statute from the way it appeared in 2014 Ky. Acts ch. 47, sec. 1, under the authority of KRS § 7.136(1)(c).
(2) Any health benefit plan issued or renewed on or after January 1, 2015, that provides coverage for prescription eye drops shall not deny coverage for a refill of a prescription if:
Terms Used In Kentucky Statutes 304.17A-166
- Statute: A law passed by a legislature.
(a) The refill is requested by the insured:
1. For a thirty (30) day supply, between twenty-five (25) days and thirty
(30) days from the later of:
a. The original date the prescription was distributed to the insured; or b. The date the most recent refill was distributed to the insured; and
2. For a ninety (90) day supply, between eighty (80) days and ninety (90)
days from the later of:
a. The original date the prescription was distributed to the insured; or b. The date the most recent refill was distributed to the insured; and
(b) The prescribing practitioner indicates on the original prescription that additional quantities are needed, and the refill requested by the insured does not exceed the number of additional quantities needed.
(3) (a) Any health benefit plan issued or renewed on or after January 1, 2015, that provides coverage for prescription eye drops shall provide coverage for one (1) additional bottle of prescription eye drops, pursuant to KRS § 304.17A-165, when:
1. The additional bottle is requested by the insured or the prescribing practitioner at the time the original prescription is distributed to the insured; and
2. The prescribing practitioner indicates on the original prescription that the additional bottle is needed by the insured for use in a day care center or school.
(b) Coverage for an additional bottle shall be limited to one (1) bottle every three
(3) months.
(4) The coverages required by this section shall not be subject to a greater deductible or copayment than other similar health care services provided by the health benefit plan.
Effective: January 1, 2015
History: Created 2014 Ky. Acts ch. 47, sec. 1, effective January 1, 2015.
Legislative Research Commission Note (1/1/2015). In codification, the Reviser of Statutes has altered the numbering within subsection (3) of this statute from the way it appeared in 2014 Ky. Acts ch. 47, sec. 1, under the authority of KRS § 7.136(1)(c).