Michigan Laws 500.3406u – Coverage for prescription eyedrops; requirements; “prescriber” defined
Current as of: 2023 | Check for updates
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Terms Used In Michigan Laws 500.3406u
- Health insurance policy: means an expense-incurred hospital, medical, or surgical policy, certificate, or contract. See Michigan Laws 500.608
- insured: as used in this chapter , shall not be construed as preventing a person other than the insured with a proper insurable interest from making application for and owning a policy covering the insured or from being entitled under such a policy to any indemnities, benefits and rights provided therein. See Michigan Laws 500.3462
- Insurer: means an individual, corporation, association, partnership, reciprocal exchange, inter-insurer, Lloyds organization, fraternal benefit society, or other legal entity, engaged or attempting to engage in the business of making insurance or surety contracts. See Michigan Laws 500.106
- state: when applied to the different parts of the United States, shall be construed to extend to and include the District of Columbia and the several territories belonging to the United States; and the words "United States" shall be construed to include the district and territories. See Michigan Laws 8.3o
(1) An insurer that delivers, issues for delivery, or renews in this state a health insurance policy that provides coverage for prescription eyedrops shall not deny coverage for a refill of the prescription if all of the following apply:
(a) For a 30-day supply, the amount of time has passed within which the insured should have used 75% of the dosage units of the drug according to the prescriber’s instructions, or 23 days have passed after either of the following:
(i) The original date the prescription was distributed to the insured.
(ii) The date the most recent refill was distributed to the insured.
(b) The prescriber indicates on the original prescription that additional quantities are needed.
(c) The prescription eye drops prescribed by the prescriber are covered under the health insurance policy.
(2) As used in this section, “prescriber” means that term as defined in section 17708 of the public health code, 1978 PA 368, MCL 333.17708.