IC 27-13-1-23: "Out-of-plan covered services"

Sec. 23. (a) "Out-of-plan covered services" means nonemergency, self-referred covered health care services that:

(1) are obtained from a provider who is:

(A) not otherwise employed by;

(B) not under contract with; and

(C) not otherwise affiliated with;

the health maintenance organization; or

(2) are obtained from a participating provider without a referral.

(b) The term does not include uncovered services.