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§ 3906. Cost-sharing provisions

Purdon's Pennsylvania Statutes and Consolidated StatutesTitle 40 P.S. InsuranceEffective: April 20, 2015

Purdon's Pennsylvania Statutes and Consolidated Statutes
Title 40 P.S. Insurance (Refs & Annos)
Chapter 19. Medical Foods Insurance Coverage Act
Effective: April 20, 2015
40 P.S. § 3906
§ 3906. Cost-sharing provisions
(a) Applicability.--Benefits for nutritional supplements (formulas) as medically necessary for the therapeutic treatment of phenylketonuria, branched-chain ketonuria, galactosemia and homocystinuria as administered under the direction of a physician shall be subject to copayment and coinsurance provisions of a health insurance policy to the extent that other medical services covered by the policy are subject to those provisions.
(a.1) Amino acid-based elemental medical formula.--Benefits for amino acid-based elemental medical formula ordered by a physician as medically necessary for food protein allergies, food protein-induced enterocolitis syndrome, eosinophilic disorders and short-bowel syndrome shall be subject to copayment and coinsurance provisions of a health insurance policy to the extent that other medical services covered by the policy are subject to those provisions.
(b) Exemption.--Benefits for nutritional supplements (formulas) as medically necessary for the therapeutic treatment of phenylketonuria, branched-chain ketonuria, galactosemia and homocystinuria as administered under the direction of a physician shall be exempt from deductible provisions in a health insurance policy. This exemption must be explicitly provided for in the policy.

Credits

1996, Dec. 20, P.L. 1492, No. 191, § 6, effective June 20, 1997. Amended 2014, Oct. 22, P.L. 2564, No. 158, § 1, effective in 180 days [April 20, 2015].
40 P.S. § 3906, PA ST 40 P.S. § 3906
Current through Act 10 of the 2024 Regular Session. Some statute sections may be more current, see credits for details.
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