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- Alaska Statutes.
- Title 21. Insurance
- Chapter 42. The Insurance Contract
- Section 380. Coverage For Treatment of Phenylketonuria.
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AS 21.42.380. Coverage For Treatment of Phenylketonuria.
- (a) Except for a fraternal benefit society, a health care insurer that offers, issues for delivery, delivers, or renews in
this state a health care insurance plan shall provide coverage under the plan for the formulas necessary for the
treatment of phenylketonuria. This subsection does not apply to a health care insurance plan that the director has
determined by order should be excluded from this subsection.
- (b) A health care insurer providing coverage under this section may impose reasonable contract limitations but may not
refuse coverage based on a preexisting condition of phenylketonuria or require that an individual covered under the
plan pay a higher deductible or copayment for the cost of treating phenylketonuria than for the cost of treating
another condition or illness.
- (c) In this section, "cost" means the lowest of the following:
- (1) the actual charge for the treatment received for phenylketonuria;
- (2) the usual, customary, and reasonable charge for the treatment as determined by the contract of coverage; or
- (3) the charge agreed to by contract between the treatment provider and the health care insurer.
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