5-10-8-14.8. Employee Health Plan Providing Coverage for Prescription Eye Drops
Sec. 14.8. (a) This section applies to an employee health plan that provides coverage for prescription eye drops. (b) As used in this section, “covered individual” means an individual who is entitled to coverage under a state employee health plan. (c) As used in this section, “state employee health plan” means one (1) of the […]
5-10-8-14.9. Coverage of Methadone
Sec. 14.9. (a) This section applies to an employee health plan that is established, entered into, amended, or renewed after June 30, 2015. (b) As used in this section, “state employee health plan” means one (1) of the following: (1) A self-insurance program established under section 7(b) of this chapter to provide group health coverage. […]
5-10-8-15. Coverage for Care Related to Cancer Clinical Trials
Sec. 15. (a) As used in this section, “care method” means the use of a particular drug or device in a particular manner. (b) As used in this section, “clinical trial” means a Phase I, II, III, or IV research study: (1) that is conducted: (A) using a particular care method to prevent, diagnose, or […]
5-10-8-16. High Breast Density
Sec. 16. (a) As used in this section, “covered individual” means an individual who is entitled to coverage under a state employee health plan. (b) As used in this section, “high breast density” means a condition in which there is a greater amount of breast and connective tissue in comparison to fat in the breast. […]
5-10-8-16.5. Post-Mastectomy Coverage
Sec. 16.5. (a) As used in this section, “covered individual” means an individual who is entitled to coverage under a state employee health plan. (b) As used in this section, “mastectomy” means the removal of all or part of a breast for reasons that are determined by a licensed physician to be medically necessary. (c) […]
5-10-8-17. Step Therapy Protocol
Sec. 17. (a) As used in this section, “covered individual” means an individual entitled to coverage under a state employee health plan. (b) As used in this section, “preceding prescription drug” means a prescription drug that, according to a step therapy protocol, must be: (1) first used to treat a covered individual’s condition; and (2) […]
5-10-8-18. Prescription Drug Coverage
Sec. 18. (a) The definitions in section 17 of this chapter apply throughout this section. (b) This section applies to a state employee health plan that uses a formulary, cost sharing, or utilization review for prescription drug coverage. (c) A state employee health plan shall not remove a prescription drug from the state employee health […]
5-10-8-19. Prior Authorization
Sec. 19. A self-insurance program established under section 7(b) of this chapter to provide health care coverage shall comply with the prior authorization requirements that apply to a health plan under IC 27-1-37.5. As added by P.L.77-2018, SEC.1.
5-10-8-20. Right to Provide Prescription Cost Information; Point of Sale Cost Limit; Pharmacist May Not Be Required to Collect Higher Copayment
Sec. 20. (a) As used in this section, “covered individual” means an individual entitled to coverage under a state employee plan. (b) As used in this section, “drug” means a prescription drug. (c) As used in this section, “pharmacy” refers to a pharmacist or pharmacy that has entered into an agreement with a state employee […]
5-10-8-21. Coverage for Anatomical Gifts, Transplantation, or Related Health Care Services
Sec. 21. (a) As used in this section, “covered individual” means an individual who: (1) is entitled to coverage under a state employee health plan; and (2) has a disability (as defined 42 U.S.C. 12102). (b) As used in this section, “state employee health plan” means either of the following that provides coverage for anatomical […]