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304.17C-120 Prescription eye drops coverage to include refills and additional bottle
if conditions met.
(1)
(2)
(3)
(4)
As used in this section, "practitioner" has the same meaning as in KRS 217.015.
Any limited health service benefit plan issued or renewed on or after January 1,
2015, that provides coverage for prescription eye drops shall not deny coverage for
a refill of a prescription if:
(a) The refill is requested by the insured:
1.
For a thirty (30) day supply, between twenty-five (25) days and thirty
(30) 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; and
2.
For a ninety (90) day supply, between eighty (80) days and ninety (90)
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; and
(b) The prescribing practitioner indicates on the original prescription that
additional quantities are needed, and the refill requested by the insured does
not exceed the number of additional quantities needed.
(a) Any limited health service benefit plan issued or renewed on or after January
1, 2015, that provides coverage for prescription eye drops shall provide
coverage for one (1) additional bottle of prescription eye drops, pursuant to
KRS 304.17A-165, when:
1.
The additional bottle is requested by the insured or the prescribing
practitioner at the time the original prescription is distributed to the
insured; and
2.
The prescribing practitioner indicates on the original prescription that
the additional bottle is needed by the insured for use in a day care center
or school.
(b) Coverage for an additional bottle shall be limited to one (1) bottle every three
(3) months.
The coverages required by this section shall not be subject to a greater deductible or
copayment than other similar health care services provided by the limited health
service benefit plan.
Effective: January 1, 2015
History: Created 2014 Ky. Acts ch. 47, sec. 2, effective January 1, 2015.
Legislative Research Commission Note (1/1/2015). In codification, the Reviser of
Statutes has altered the numbering within subsection (3) of this statute from the way
it appeared in 2014 Ky. Acts ch. 47, sec. 2, under the authority of KRS 7.136(1)(c).
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