Section 6. Cost-sharing provisions.
(a) Applicability.--Benefits for nutritional supplements (formulas) as medically necessary for the therapeutic treatment of phenylketonuria, branched-chain ketonuria, galactosemia and homocystinuria as administered under the direction of a physician shall be subject to copayment and coinsurance provisions of a health insurance policy to the extent that other medical services covered by the policy are subject to those provisions.
(a.1) Amino acid-based elemental medical formula.--Benefits for amino acid-based elemental medical formula ordered by a physician as medically necessary for food protein allergies, food protein-induced enterocolitis syndrome, eosinophilic disorders and short-bowel syndrome shall be subject to copayment and coinsurance provisions of a health insurance policy to the extent that other medical services covered by the policy are subject to those provisions.
(b) Exemption.--Benefits for nutritional supplements (formulas) as medically necessary for the therapeutic treatment of phenylketonuria, branched-chain ketonuria, galactosemia and homocystinuria as administered under the direction of a physician shall be exempt from deductible provisions in a health insurance policy. This exemption must be explicitly provided for in the policy.
(6 amended Oct. 22, 2014, P.L.2564, No.158)