405 IAC 10-7-3 - HIP Plus covered benefits and services; noncovered services
Authority: IC 12-15-44.5
Affected: IC 12-15-44.5
Sec. 3.
(a) This
section outlines the services available to an individual enrolled in HIP Plus.
The covered services provided under HIP Plus are in accordance with the
essential health benefit requirements under
42 CFR
440.347 for alternative benefit
plans.
(b) HIP Plus shall include
covered services in each of the following categories:
(1) Ambulatory patient services.
(2) Emergency services.
(3) Hospitalization.
(4) Maternity services.
(5) Mental health and substance abuse
services.
(6) Prescription
drugs.
(7) Rehabilitative and
habilitative services and devices.
(8) Laboratory services.
(9) Preventive care services.
(10) Vision services.
(11) Dental services.
(12) Early and periodic screening,
diagnostic, and treatment services for members nineteen (19) and twenty (20)
years of age.
(13) Any other
services approved by the Centers for Medicare and Medicaid Services in the HIP
Plus alternative benefit plan.
(c) The following services shall not be
covered under HIP Plus:
(1) Services that are
not medically necessary.
(2)
Nonemergency transportation services.
(3) Any other services not approved by the
Centers for Medicare and Medicaid Services in the HIP Plus alternative benefit
plan.
Notes
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No prior version found.