§ 27-8-14.1-4 — Coverage for nonexperimental, surgical treatment of morbid obesity

Indiana § 27-8-14.1-4

• Jurisdiction: Indiana
• Title 27: INSURANCE
• Art. 8: LIFE, ACCIDENT, AND HEALTH
• Ch. 14.1: Coverage for Services Related to Morbid Obesity

Text

(a) Except as provided in subsection (b), an
insurer that issues an accident and sickness insurance policy shall offer
coverage for nonexperimental, surgical treatment by a health care
provider of morbid obesity:
(1) that has persisted for at least five (5) years; and
(2) for which nonsurgical treatment that is supervised by a
physician has been unsuccessful for at least six (6) consecutive
months.
(b) An insurer that issues an accident and sickness insurance policy
may not provide coverage for a surgical treatment of morbid obesity for
an insured who is less than twenty-one (21) years of age unless two (2)
physicians licensed under IC 25-22.5 determine that the surgery is
necessary to:
(1) save the life of the insured; or
(2) restore the insured's ability to maintain a major life activity (as
defined in IC 4-23-29-6);
and each physician documents in the insured's medical record the
reason for the physician's determination.

Legislative History

As added by P.L.78-2000, SEC.2. Amended by P.L.196-2005, SEC.5; P.L.102-2006, SEC.4.