Section 405 IAC 10-7-8 - Preventive care servicesAuthority: IC 12-15-44.5-9
Affected: IC 12-15-44.5
Sec. 8.
(a) Preventive care services as set forth in 42 U.S.C. 300gg-13 shall be covered, regardless of whether the member has met the member's deductible, and shall not be reimbursed using the member's POWER account.(b) Preventive care services not set forth in 42 U.S.C. 300gg-13 shall be covered up to five hundred dollars ($500) during the member's benefit period, regardless of whether the member has met the member's deductible, and shall not be reimbursed using the member's POWER account. Any such services in excess of five hundred dollars ($500) shall be covered but shall be subject to the member's deductible and shall be reimbursed using the member's POWER account.(c) A member's failure to receive preventive care services applicable to the member during the benefit period may impact the rollover of POWER account funds as outlined in 405 IAC 10-10-5(c) and 405 IAC 10-10-5(d).(d) If a managed care organization determines that a member has not met the member's preventive care requirements during the benefit period, such member may submit documentation to the managed care organization showing that the member received the required preventive care services. Filed 5/18/2015, 12:34 p.m.: 20150617-IR-405140339FRAFiled 1/19/2018, 8:42 a.m.: 20180214-IR-405170484FRA