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§ 764n. Coverage for refill of prescription eye drops

Purdon's Pennsylvania Statutes and Consolidated StatutesTitle 40 P.S. InsuranceEffective: January 3, 2023

Purdon's Pennsylvania Statutes and Consolidated Statutes
Title 40 P.S. Insurance (Refs & Annos)
Chapter 2. Insurance Companies (Refs & Annos)
Article VI. Casualty Insurance (Refs & Annos)
(b) Health and Accident Insurance (Refs & Annos)
Effective: January 3, 2023
40 P.S. § 764n
§ 764n. Coverage for refill of prescription eye drops
Currentness
<For applicability of the addition of this section by Act 2022, Nov. 3, P.L. 2173, No. 162, see § 2 of that Act.>
(a) A health insurance policy offered, issued or renewed in this Commonwealth shall provide coverage for a prescription eye drops refill if the refill:
(1) Is requested:
(i) For a thirty-day supply, between twenty-one and thirty days of the later of:
(A) the original date the prescription was distributed to the insured; or
(B) the date the most recent refill was distributed to the insured.
(ii) For a sixty-day supply, between forty-two and sixty days from the later of:
(A) the original date the prescription was distributed to the insured; or
(B) the date the most recent refill was distributed to the insured.
(iii) For a ninety-day supply, between sixty-three and ninety days from the later of:
(A) the original date the prescription was distributed to the insured; or
(B) the date the most recent refill was distributed to the insured.
(2) Is prescribed by a health care practitioner and is a covered benefit under the health insurance policy of the insured.
(3) Does not exceed the total number of refills indicated on the original prescription.
(b) As used in this section:
“Health insurance policy” means an individual or group insurance policy, subscriber contract, certificate or plan issued by an insurer that provides medical or health care coverage, including emergency services. The term does not include:
(1) An accident only policy.
(2) A credit only policy.
(3) A long-term care or disability income policy.
(4) A specified disease policy.
(5) A Medicare supplement policy.
(6) A TRICARE policy, including a Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) supplement policy.
(7) A fixed indemnity policy.
(8) A hospital indemnity policy.
(9) A dental only policy.
(10) A vision only policy.
(11) A workers' compensation policy.
(12) An automobile medical payment policy.
(13) A homeowners' insurance policy.
(14) A short-term limited duration policy.
(15) Any other similar policy providing for limited benefits.
“Insurer” means an entity licensed by the department with accident and health authority to issue a health insurance policy that is offered or governed under any of the following:
(1) This act, including section 6301 and Article XXIV.2
(2) The act of December 29, 1972 (P.L. 1701, No. 364),3 known as the “Health Maintenance Organization Act.”
(3) 40 Pa.C.S. Ch. 61 (relating to hospital plan corporations) or 63 (relating to professional health services plan corporations).

Credits

1921, May 17, P.L. 682, No. 284, art. VI, § 635.8, added 2022, Nov. 3, P.L. 2173, No. 162, § 1, effective in 60 days [Jan. 3, 2023].

Footnotes

1
40 P.S. § 764a.
2
40 P.S. § 991.2401 et seq.
3
40 P.S. § 1551 et seq.
40 P.S. § 764n, PA ST 40 P.S. § 764n
Current through Act 10 of the 2024 Regular Session. Some statute sections may be more current, see credits for details.
End of Document