- (1) Each individual policy, certificate of insurance, and membership contract that is delivered, issued for delivery, renewed, extended, or modified in this state must provide coverage for outpatient self-management training and education for the treatment of diabetes. Any education must be provided by a licensed health care professional with expertise in diabetes.
(2)
(a) Coverage must include an annual benefit for medically necessary and prescribed outpatient self-management training and education for the treatment of diabetes. At a minimum, the benefit must consist of:
- (i) 20 visits of training and education in diabetes self-management in either an individual or group setting within the first year of diagnosis if the insured has not received the training and education previously; and
- (ii) 12 visits of followup diabetes self-management training and education services in subsequent years for an insured who has previously received and exhausted the initial 20 visits of education under subsection (2)(a)(i).
- (b) Nothing in subsection (2)(a) prohibits an insurer from providing a greater benefit.
- (c) For the purposes of this subsection (2), the term "visit" refers to a period of 30 minutes.
- (3) Annual copayment and deductible provisions are subject to the same terms and conditions applicable to all other covered benefits within a given policy.
- (4) This section does not apply to disability income, hospital indemnity, medicare supplement, accident-only, vision, dental, specific disease, or long-term care policies.
History: En. Sec. 1, Ch. 520, L. 2023.