Islets of Hope state diabetes insurance coverage laws

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Information for this article was compiled and edited by Lahle A. Wolfe, Islets of Hope.

Important Disclaimer

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.


Article Sources

National Conference of State Legislatures

Government Accountability Office (GAO) report number GAO-05-210 entitled "Managing Diabetes: Health Plan Coverage of Services and Supplies;" released on March 28, 2005.


Oregon State Laws Affecting Diabetes Care at School

Federal Laws Pertaining to Persons with Diabetes

Diabetes Assistance Programs

Diabetes Laws

Oregon - State Diabetes Insurance Coverage Laws


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Oregon has state-mandated laws that require insurance carriers to cover diabetes care and education services.

S 286 of 2001 - signed 7/4/01. Requires coverage for supplies, equipment and self-management programs.  

A 1987 law, ORS §743.704 covered diabetes self-management education. Part of that provision expired, but most insurers continued to provide coverage.

Summary of Provisions

  • Requirement related to diabetes?  Yes
  • Diabetes Education services covered?  Yes
  • Medical nutritional therapy covered?  No
  • Diabetes supplies covered?  Yes
  • Specified supplies covered?  No

NOTE:  Mandates only apply to group insurance policies.

Oregon Department of Consumer and Business Services - Insurance Division

Oregon Health Insurance Laws - Diabetes Coverage

From the Oregon Legislative Website:

    Senate Bill 286 - Relating to health insurance coverage; creating new provisions; amending ORS 750.055 and 750.333; and repealing ORS 743.704.

    SB 286 (ch 742) Coverage of diabetes services requires group health benefit plans to cover costs of supplies, equipment and diabetes self-management.

    SECTION 2. { + (1) Subject to other terms, conditions and benefits in the plan, group health benefit plans as described in ORS 743.730 shall provide payment, coverage or reimbursement for supplies, equipment and diabetes self-management programs associated with the treatment of insulin-dependent diabetes, insulin-using diabetes, gestational diabetes and noninsulin-using diabetes prescribed by a health care professional legally authorized to prescribe such items. (2) As used in this section, 'diabetes self-management program' means one program of assessment and training after diagnosis and no more than three hours per year of assessment and training upon a material change of condition, medication or treatment that is provided by: (a) An education program credentialed or accredited by a state or national entity accrediting such programs; or (b) A program provided by a physician licensed under ORS chapter 677, a registered nurse, a nurse practitioner, a certified diabetes educator or a licensed dietitian with demonstrated expertise in diabetes.  

 

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Page Updated  03/11/2007