Indiana health plans would cover medically needed brain injury treatment

Eligible insurers and health maintenance organizations would cover medically needed brain injury treatment. The rule covers people with eligible insurance policies or health maintenance organization contracts who have a brain injury after birth from a listed or related cause. Treatment must follow accepted medical practice. The insurance policy rule excludes some plans named elsewhere in Indiana law. The proposed rule would start July 1, 2026, and apply to policies issued, delivered, or renewed and contracts entered, amended, or renewed after June 30, 2026.

Covered plans would limit annual caps and patient charges and would have no lifetime cap on this treatment. These limits apply to the brain injury treatment covered by eligible insurance policies and health maintenance organization contracts. Any annual cap must be listed separately. Annual caps, deductibles, copays, and the patient's share of a bill cannot be stricter than the plan's general terms. The limits would apply to policies issued, delivered, or renewed and contracts entered, amended, or renewed after June 30, 2026.

Brain injury care providers and facilities would need the qualifications normally expected for their work. This applies to people and facilities providing brain injury treatment to members of the covered policies and contracts. The required licenses, accreditation, training, and experience must be those normally expected for the work. The requirement would apply to policies issued, delivered, or renewed and contracts entered, amended, or renewed after June 30, 2026.