Individual or Group Contract Providing Coverage for Prescription Eye Drops; Refill of Prescription Eye Drops; Requirements

Checkout our iOS App for a better way to browser and research.

Sec. 20.1. (a) This section applies to an individual contract or a group contract that provides coverage for prescription eye drops.

(b) An individual contract or a group contract must provide coverage for a refill of prescription eye drops if the following are met:

(1) For a thirty (30) day supply, the enrollee requests the refill not earlier than twenty-five (25) days from the date the prescription eye drops were last dispensed to the enrollee.

(2) For a ninety (90) day supply, the enrollee requests the refill not earlier than seventy-five (75) days from the date the prescription eye drops were last dispensed to the enrollee.

(3) The prescribing practitioner has indicated on the prescription that the prescription eye drops are refillable and the refill requested by the enrollee does not exceed the refillable amount remaining on the prescription.

(c) The coverage required by subsection (b) must not be subject to dollar limits, copayments, deductibles, or coinsurance provisions that are less favorable to an enrollee than the dollar limits, copayments, deductibles, or coinsurance provisions that apply to coverage for prescription drugs generally under the individual contract or group contract.

(d) This section applies to an individual contract or a group contract issued, delivered, amended, or renewed after December 31, 2015.

As added by P.L.43-2015, SEC.3.


Download our app to see the most-to-date content.