Tex.
Ins. Code Section 1358.054
Coverage Required
(a)
A health benefit plan that provides coverage for the treatment of diabetes and conditions associated with diabetes must provide to each qualified enrollee coverage for:(1)
diabetes equipment;(2)
diabetes supplies; and(3)
diabetes self-management training in accordance with the requirements of Section 1358.055 (Diabetes Self-management Training).(a-1)
A health benefit plan described by Subsection (a) must provide to each qualified enrollee coverage for emergency refills of diabetes equipment or diabetes supplies dispensed to the enrollee in accordance with Section 562.0541 (Emergency Refills of Insulin and Insulin-related Equipment or Supplies), Occupations Code, in the same manner as for a nonemergency refill of diabetes equipment or diabetes supplies.(b)
A health benefit plan may require a deductible, copayment, or coinsurance for coverage provided under this section. The amount of the deductible, copayment, or coinsurance may not exceed the amount of the deductible, copayment, or coinsurance required for treatment of other analogous chronic medical conditions.
Source:
Section 1358.054 — Coverage Required, https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1358.htm#1358.054 (accessed Jun. 5, 2024).
