Ind. Code § 27-8-14.8-3
Coverage for colorectal cancer screening; exception for grandfathered health plans
Redline — January 1, 2018 → current.View current text →
Current — January 1, 2023
As of January 1, 2018
Sec. 3. (a) As used in this section, "follow-up colonoscopy" means a colonoscopy that is performed as a follow-up to a colorectal cancer screening test, other than a colonoscopy, that is assigned a grade of "A" or "B" by the United States Preventive Services Task Force and for which the result was positive.
(b) Except as provided in subsection (e), an insurer shall provide coverage for colorectal cancer examinations and laboratory tests for cancer for any nonsymptomatic insured in any accident and sickness insurance policy that the insurer issues in Indiana or issues for delivery in Indiana. Except as provided in subsection (f), covered services must include:
(1) a colorectal cancer screening test assigned either an "A" or "B" grade by the United States Preventive Services Task Force; and
(2) a follow-up colonoscopy.
(c) For an insured who is:
(1) at least fifty (50) years of age; or
(1) at least forty-five (45) years of age; or
(2) less than fifty (50) years of age and at high risk for colorectal cancer according to the American Cancer Society guidelines;
(2) less than forty-five (45) years of age and at high risk for colorectal cancer;
the coverage required under this section must meet the requirements set forth in subsection (c).
the coverage required under this section must meet the requirements set forth in subsection (d), except as provided in subsection (f).
(d) An insured may not be required to pay an additional annual deductible or coinsurance for the colorectal cancer examination and laboratory testing benefit required by this section that is greater than an annual deductible or coinsurance established for similar benefits under the accident and sickness insurance policy under which the insured is covered. If the accident and sickness insurance policy does not cover a similar benefit, a deductible or coinsurance for the colorectal cancer examination and laboratory testing benefit may not be set at a level that materially diminishes the value of the colorectal cancer examination and laboratory testing benefit.
(e) In the case of an accident and sickness insurance policy that is not employer based, the insurer shall offer to provide the coverage described in this section.
(f) The requirements imposed under subsection (b)(2) do not apply to grandfathered health plans as defined in 45 CFR 147.140.
Official source: Indiana General Assembly. Reproduced from public-domain Indiana statutes; confirm against the official source for the current text. Not legal advice.