CHAPTER 14.8. COVERAGE FOR SERVICES RELATED TO COLORECTAL CANCER SCREENING
IC 27-8-14.8
Chapter 14.8. Coverage for Services Related to Colorectal Cancer
Screening
IC 27-8-14.8-1
"Accident and sickness insurance policy" defined
Sec. 1. (a) As used in this chapter, "accident and sickness
insurance policy" means an insurance policy that:
(1) provides at least one (1) of the types of insurance described
in IC 27-1-5-1, Classes 1(b) and 2(a); and
(2) is issued on a group basis.
(b) "Accident and sickness insurance policy" does not include the
following:
(1) Accident only, credit, dental, vision, Medicare supplement,
long term care, or disability income insurance.
(2) Coverage issued as a supplement to liability insurance.
(3) Worker's compensation or similar insurance.
(4) Automobile medical payment insurance.
(5) A specified disease policy.
(6) A short term insurance plan that:
(A) may not be renewed; and
(B) has a duration of not more than six (6) months.
(7) A policy that provides indemnity benefits not based on any
expense incurred requirement, including a plan that provides
coverage for:
(A) hospital confinement, critical illness, or intensive care;
or
(B) gaps for deductibles or copayments.
(8) A supplemental plan that always pays in addition to other
coverage.
(9) A student health plan.
(10) An employer sponsored health benefit plan that is:
(A) provided to individuals who are eligible for Medicare;
and
(B) not marketed as, or held out to be, a Medicare
supplement policy.
As added by P.L.54-2000, SEC.2. Amended by P.L.173-2007,
SEC.35.
IC 27-8-14.8-2
"Insured" defined
Sec. 2. As used in this chapter, "insured" means an individual who
is entitled to coverage under an accident and sickness insurance
policy.
As added by P.L.54-2000, SEC.2.
IC 27-8-14.8-3
Colorectal cancer testing coverage
Sec. 3. (a) Except as provided in subsection (d), an insurer shall
provide coverage for colorectal cancer examinations and laboratory
tests for cancer for any nonsymptomatic insured, in accordance with
the current American Cancer Society guidelines, in any accident and
sickness insurance policy that the insurer issues in Indiana or issues
for delivery in Indiana.
(b) For an insured who is:
(1) at least fifty (50) years of age; or
(2) less than fifty (50) years of age and at high risk for
colorectal cancer according to the most recent published
guidelines of the American Cancer Society;
the coverage required under this section must meet the requirements
set forth in subsection (c).
(c) An insured may not be required to pay an additional annual
deductible or coinsurance for the colorectal cancer examination and
laboratory testing benefit that is greater than an annual deductible or
coinsurance established for similar benefits under an accident and
sickness insurance policy. If the accident and sickness insurance
policy does not cover a similar benefit, a deductible or coinsurance
may not be set at a level that materially diminishes the value of the
colorectal cancer examination and laboratory testing benefit required
under this section.
(d) 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.
As added by P.L.54-2000, SEC.2.