{"data":{"id":"us-in/ic-27-8-5-2.5","jurisdiction":"us-in","citation":"IC 27-8-5-2.5","heading":"Coverage under individual, and certain association group, policies of accident and sickness insurance; waivers","body":"Sec. 2.5. (a) As used in this section, the term \"policy of accident and sickness insurance\" does not include the following:\n(1) Accident only, credit, dental, vision, Medicare supplement, long term care, or disability income insurance.\n(2) Coverage issued as a supplement to liability insurance.\n(3) Automobile medical payment insurance.\n(4) A specified disease policy.\n(5) A short term insurance plan that:\n(A) may be renewed for the greater of:\n(i) thirty-six (36) months; or\n(ii) the maximum period permitted under federal law;\n(B) has a term of not more than three hundred sixty-four (364) days; and\n(C) has an annual limit of at least two million dollars ($2,000,000).\n(6) A policy that provides indemnity benefits not based on any expense incurred requirement, including a plan that provides coverage for:\n(A) hospital confinement, critical illness, or intensive care; or\n(B) gaps for deductibles or copayments.\n(7) Worker's compensation or similar insurance.\n(8) A student health plan.\n(9) A supplemental plan that always pays in addition to other coverage.\n(10) An employer sponsored health benefit plan that is:\n(A) provided to individuals who are eligible for Medicare; and\n(B) not marketed as, or held out to be, a Medicare supplement policy.\n(b) The benefits provided by:\n(1) an individual policy of accident and sickness insurance; or\n(2) a certificate of coverage that is issued under a nonemployer based association group policy of accident and sickness insurance to an individual who is a resident of Indiana;\nmay not be excluded, limited, or denied for more than twelve (12) months after the effective date of the coverage because of a preexisting condition of the individual.\n(c) An individual policy of accident and sickness insurance or a certificate of coverage described in subsection (b) may not define a preexisting condition, a rider, or an endorsement more restrictively than as:\n(1) a condition that would have caused an ordinarily prudent person to seek medical advice, diagnosis, care, or treatment during the twelve (12) months immediately preceding the effective date of the plan;\n(2) a condition for which medical advice, diagnosis, care, or treatment was recommended or received during the twelve (12) months immediately preceding the effective date of the plan; or\n(3) a pregnancy existing on the effective date of the plan.\n(d) An insurer shall reduce the period allowed for a preexisting condition exclusion described in subsection (b) by the amount of time the individual has continuously served under a preexisting condition clause for a policy of accident and sickness insurance issued under IC 27-8-15 if the individual applies for a policy under this chapter not more than thirty (30) days after coverage under a policy of accident and sickness insurance issued under IC 27-8-15 expires.","path":["TITLE 27. INSURANCE","ARTICLE 8. LIFE, ACCIDENT, AND HEALTH","Chapter 5. Accident and Sickness Insurance─Policy Provisions"],"source_url":"https://iga.in.gov/ic/2026/Title_27.html#27-8-5-2.5","current_through":"2026","vintage":"2026","retrieved_at":"2026-09-25T05:39:04Z","sha256":"6155067aa0562df5abf77d5bc751df981f308e3077094589e19f09a5ae9829ab","source_id":"us-in","stale":false,"prev":"us-in/ic-27-8-5-2","next":"us-in/ic-27-8-5-2.6"},"notice":"GroundRules: Original legal text. Not legal advice."}