Sec. 3. (a) As used in this section, “follow-up colonoscopy” means a colonoscopy that is performed as a follow-up to a colorectal cancer screening test, other than a colonoscopy, that is assigned a grade of “A” or “B” by the United States Preventive Services Task Force and for which the result was positive.

     (b) Except as provided in subsection (e), an insurer shall provide coverage for colorectal cancer examinations and laboratory tests for cancer for any nonsymptomatic insured in any accident and sickness insurance policy that the insurer issues in Indiana or issues for delivery in Indiana. Except as provided in subsection (f), covered services must include:

Terms Used In Indiana Code 27-8-14.8-3

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

    Indiana Code 27-8-14.8-1

  • insured: means an individual who is entitled to coverage under an accident and sickness insurance policy. See Indiana Code 27-8-14.8-2
  • United States: includes the District of Columbia and the commonwealths, possessions, states in free association with the United States, and the territories. See Indiana Code 1-1-4-5
(1) a colorectal cancer screening test assigned either an “A” or “B” grade by the United States Preventive Services Task Force; and

(2) a follow-up colonoscopy.

     (c) For an insured who is:

(1) at least forty-five (45) years of age; or

(2) less than forty-five (45) years of age and at high risk for colorectal cancer;

the coverage required under this section must meet the requirements set forth in subsection (d), except as provided in subsection (f).

     (d) An insured may not be required to pay an additional annual deductible or coinsurance for the colorectal cancer examination and laboratory testing benefit required by this section that is greater than an annual deductible or coinsurance established for similar benefits under the accident and sickness insurance policy under which the insured is covered. If the accident and sickness insurance policy does not cover a similar benefit, a deductible or coinsurance for the colorectal cancer examination and laboratory testing benefit may not be set at a level that materially diminishes the value of the colorectal cancer examination and laboratory testing benefit.

     (e) 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.

     (f) The requirements imposed under subsection (b)(2) do not apply to grandfathered health plans as defined in 45 C.F.R. § 147.140.

As added by P.L.54-2000, SEC.2. Amended by P.L.124-2018, SEC.82; P.L.36-2020, SEC.2; P.L.165-2022, SEC.12.

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