Section 21.55.120. Deductibles and copayments.

   (a) A state plan other than a Medicare supplement plan may require a deductible of not less than $500 a person as determined by the board and approved by the director. The amount of the deductible may not be greater when a service is rendered on an outpatient basis than when that service is offered on an inpatient basis. Expenses incurred during the last three months of a calendar year and actually applied to an individual's deductible for that year shall also be applied to that individual's deductible in the following calendar year.
   (b) A state plan other than a Medicare supplement plan shall require a maximum copayment of 20 percent for charges for all types of health care in excess of the deductible and 50 percent for services described in AS 21.55.110(3) in excess of the deductible.
   (c) The sum of the deductible and copayments required in any calendar year under a plan may not exceed a maximum limit of $1,500 plus the deductible. Covered expenses incurred after the applicable maximum limit has been reached shall be paid at the rate of 100 percent of usual, customary, reasonable, or prevailing charges, except that expenses incurred for treatment of mental and nervous conditions shall be paid at the rate of 50 percent.
   (d)  [Repealed, Sec. 24 ch 31 SLA 1999]. 
   (e)  [Repealed, Sec. 24 ch 31 SLA 1999]. 

Authorities

21.55.100;21.55.110;21.55.500

Notes

References

AS 21.55.100 Types of insurance plans.
AS 21.55.110 Minimum benefits of state health insurance plan.
AS 21.55.500 Definitions.

History

(Sec. 2 ch 126 SLA 1992; am Sec. 4, 5 ch 125 SLA 1994; am Sec. 6, 7, 24 ch 31 SLA 1999)