IC 27-8-24.1
    Chapter 24.1. Coverage for Treatment of Inherited MetabolicDisease

IC 27-8-24.1-1
"Accident and sickness insurance policy"
    Sec. 1. (a) As used in this chapter, "accident and sicknessinsurance policy" means an insurance policy that provides at leastone (1) of the types of insurance described in IC 27-1-5-1, Classes1(b) and 2(a), and is issued on a group basis.
    (b) The term 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 anyexpense incurred requirement, including a plan that providescoverage 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 othercoverage.
        (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 Medicaresupplement policy.
As added by P.L.166-2003, SEC.2. Amended by P.L.173-2007,SEC.41.

IC 27-8-24.1-2
"Covered individual"
    Sec. 2. As used in this chapter, "covered individual" means anindividual who is entitled to coverage under an accident and sicknessinsurance policy.
As added by P.L.166-2003, SEC.2.

IC 27-8-24.1-3
"Inherited metabolic disease"
    Sec. 3. As used in this chapter, "inherited metabolic disease"means a disease:
        (1) caused by inborn errors of amino acid, organic acid, or ureacycle metabolism; and        (2) treatable by the dietary restriction of one (1) or more aminoacids.
As added by P.L.166-2003, SEC.2.

IC 27-8-24.1-4
"Medical food"
    Sec. 4. As used in this chapter, "medical food" means a formulathat is:
        (1) intended for the dietary treatment of a disease or conditionfor which nutritional requirements are established by medicalevaluation; and
        (2) formulated to be consumed or administered enterally underthe direction of a physician.
As added by P.L.166-2003, SEC.2.

IC 27-8-24.1-5
Coverage for medical food
    Sec. 5. An accident and sickness insurance policy must providecoverage for medical food that is:
        (1) medically necessary; and
        (2) prescribed by a covered individual's treating physician fortreatment of the covered individual's inherited metabolicdisease.
As added by P.L.166-2003, SEC.2.

IC 27-8-24.1-6
Dollar limits, out-of-pocket expenses
    Sec. 6. The coverage that must be provided under this chaptershall not be subject to dollar limits, coinsurance, or deductibles thatare less favorable to a covered individual than the dollar limits,coinsurance, or deductibles that apply to coverage for:
        (1) prescription drugs generally under the accident and sicknessinsurance policy, if prescription drugs are covered under theaccident and sickness insurance policy; or
        (2) physical illness generally under the accident and sicknessinsurance policy, if prescription drugs are not covered under theaccident and sickness insurance policy.
As added by P.L.166-2003, SEC.2.