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.
New York - State Diabetes Insurance Coverage Laws
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New York has state-mandated laws that require insurance carriers to cover diabetes care and education services.
Insurance §3216i (15a); Chapter 378 of 1993 law - Requires coverage of "blood glucose monitors and blood glucose monitors for the visually impaired, data management systems, test strips for glucose monitors and visual reading and urine testing strips, insulin, injection aids, cartridges for the visually impaired, syringes, insulin pumps and appurtenances thereto, insulin infusion devices, and oral agents for controlling blood sugar; also include coverage for diabetes self-management education."
Summary of Provisions
Private Health Insurance Plans
In January 1994 the diabetes insurance law became effective. Also known as Chapter 378 of the laws of 1993; (Insurance Law §§ 2221, #3216, #4303), this law states that medically necessary diabetes self-management education and education relating to diet* will be covered when it is provided by:
*Coverage for self-management education and education relating to diet shall also include home visits when medically necessary
This law also requires insurance coverage for various diabetes equipment and related supplies. The list of equipment and related supplies which may be medically necessary for the treatment of diabetes includes but is not limited to the following items (regulatory authority: 10 NYCRR Subpart § 60-.3.1):
Insurance coverage is:
This law applies to:
This law does not apply to:
Page Updated 02/18/2007