Islets of Hope state diabetes insurance coverage laws
Information for this article was compiled and edited by Lahle A. Wolfe, Islets of Hope.
This information for general information purposes only.
It is not intended to be used a recommendation or endorse- ment of any program or entity
This information is not intended to serve as any form of medical or legal advice.
Government Accountability Office (GAO) report number GAO-05-210 entitled "Managing Diabetes: Health Plan Coverage of Services and Supplies;" released on March 28, 2005.
Colorado - State Diabetes Insurance Coverage Laws
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Colorado has state-mandated laws that require insurance carriers to cover diabetes care and education services.
§10-16-104 (13) - 1998 law - coverage "shall include equipment, supplies, and outpatient self-management training and education, including medical nutrition therapy if prescribed by a health care provider."
Summary of Provisions
Insurance Coverage Information
January 1, 2006 Colorado Standard Health Benefit Plans: Indemnity, Preferred Provider, and HMO (diabetes coverage is mentioned, including prosthesis and transplant coverage).
Bulletin 22-04 Health Coverage Compliance Guidelines (includes diabetes care), 11/2004
10-16-104(13) 1998 law
(13) Diabetes. (a) Any health benefit plan, except supplemental policies covering a specified disease or other limited benefit, that provides hospital, surgical, or medical expense insurance shall provide coverage for diabetes that shall include equipment, supplies, and outpatient self-management training and education, including medical nutrition therapy if prescribed by a health care provider licensed to prescribe such items pursuant to Colorado law, and, if coverage is provided through a managed care plan, such qualified provider shall be a participating provider in such managed care plan.
(b) Diabetes outpatient self-management training and education when prescribed shall be provided by a certified, registered, or licensed health care professional with expertise in diabetes.
(c) The benefits provided in this subsection (13) are subject to the same annual deductibles or copayments established for all other covered benefits within a given policy.
(d) Private third-party payors shall not reduce or eliminate coverage due to the requirements of this subsection (13).
Note: (28.7) "PATIENT WITH DIABETES" MEANS A PERSON WITH ELEVATED BLOOD GLUCOSE LEVELS WHO HAS BEEN DIAGNOSED AS HAVING DIABETES BY AN APPROPRIATELY LICENSED HEALTH CARE PROFESSIONAL.
Page Updated 02/18/2007