This bill amends various sections of the General Laws to ensure comprehensive coverage for diabetes treatment under health insurance policies in the state. It mandates that all individual or group health insurance contracts, plans, or policies that provide medical coverage must include coverage for essential diabetes equipment and supplies, such as insulin administration and glucose monitoring equipment and supplies, when prescribed by a physician.

Commencing January 1, 2026, the bill introduces a cap on out-of-pocket expenses for insulin administration and glucose monitoring supplies, set at no more than $25 per supply lasting 30 days, or per item when an item is intended to be used for longer than 30 days. The coverage for such equipment and supplies shall not be subject to any annual deductible. Additionally, if the application of the cap to a specific item of equipment or supply before a covered person has met their plan's deductible would result in health savings account ineligibility under 26 U.S.C. 223, then the cap would only apply to that specific item of equipment or supply after the covered person has met their plan's deductible.

The bill also includes provisions for the coverage of diabetes self-management education and medical nutrition therapy, ensuring that individuals with diabetes have more accessible and affordable treatment options.

Statutes affected:
196: 27-18-38, 27-19-35, 27-20-30, 27-41-44