Amount Paid for Prescription Drug to Be Counted Against Deductible

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Sec. 22.5. (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, "state employee health plan" means the following:

(1) A self-insurance program established under section 7(b) of this chapter.

(2) A contract for prepaid health services under section 7(c) of this chapter.

(c) A state employee health plan shall implement a procedure to allow a covered individual to submit a claim to offset the covered individual's deductible for the cost of a purchase by the covered individual of a prescription drug that:

(1) is covered under the state employee health plan; and

(2) was purchased by the covered individual without submitting at the point of purchase the claim through the state employee health plan.

(d) If a covered individual submits a claim to the state employee health plan in accordance with the procedure established under subsection (c), the state employee health plan shall verify the purchase described under subsection (c) and count the amount paid by the covered individual for the purchased covered prescription drug against the covered individual's deductible.

As added by P.L.114-2020, SEC.2.


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