Sec. 4. (a) Except as provided in subsection (f), an insurer shall provide coverage for prostate specific antigen testing in any accident and sickness insurance policy that the insurer issues in Indiana.

     (b) Except as provided in subsection (f), the coverage required under subsection (a) must include the following:

Terms Used In Indiana Code 27-8-14.7-4

  • accident and sickness insurance policy: means an insurance policy that:

    Indiana Code 27-8-14.7-1

  • insured: means a male individual who is entitled to coverage under a policy of accident and sickness insurance. See Indiana Code 27-8-14.7-2
  • prostate specific antigen test: means a standard blood test performed to determine the level of prostate specific antigen in the blood. See Indiana Code 27-8-14.7-3
(1) At least one (1) prostate specific antigen test annually for an insured who is at least fifty (50) years of age.

(2) At least one (1) prostate specific antigen test annually for an insured who is less than fifty (50) years of age and who is at high risk for prostate cancer according to the American Cancer Society guidelines.

     (c) An insured may not be required to pay an annual deductible or coinsurance that is greater than an annual deductible or coinsurance established for similar benefits under the accident and sickness insurance policy. If the policy does not cover a similar benefit, the deductible or coinsurance may not be set at a level that materially diminishes the value of the prostate specific antigen testing benefit required by this chapter.

     (d) Except as provided in subsection (f), the coverage that an insurer must provide under this chapter may not be subject to dollar limits, deductibles, or coinsurance provisions that are less favorable to the insured than the dollar limits, deductibles, or coinsurance provisions applying to physical illness generally under the accident and sickness insurance policy.

     (e) Except as provided in subsection (f), the coverage that an insurer must provide is in addition to any benefits specifically provided for x-rays, laboratory testing, or wellness examinations.

     (f) In the case of insurance policies that are not employer based, the insurer must offer to provide the coverage described in subsections (a) through (e).

As added by P.L.170-1999, SEC.4. Amended by P.L.124-2018, SEC.81.