This bill requires every individual or group health insurance policy providing coverage on an expense-incurred basis; every policy or contract issued by a hospital or medical service corporation; every individual or group service contract issued by a health maintenance organization; and every self-insured group arrangement to the extent not preempted by federal law, that is delivered, issued for delivery, entered into, amended, or renewed in Tennessee on or after July 1, 2023, to provide coverage of a continuous glucose monitor for every person with diabetes who is insulin-dependent and is covered by the policy, whether as a dependent of the policy holder or otherwise.
This bill authorizes the insurer to require a prescription by a licensed physician or to show some proof through other suitable documentation of the need for a continuous glucose monitor. Further, this bill does not preclude the insurer from conducting managed care, medical necessity, or utilization review, or prevent the operation of such policy provisions as deductibles, coinsurance, allowable charge limitations, coordination of benefits, or provisions restricting coverage to services by licensed, certified, or carrier-approved providers or facilities.
This bill does not apply to TennCare or any successor program nor to insurance coverage providing benefits for the following:
(1) Hospital confinement indemnity;
(2) Disability income;
(3) Accident only;
(4) Long-term care;
(5) Medicare supplement;
(6) Limited benefit health;
(7) Specified disease indemnity;
(8) Sickness or bodily injury, or death by accident, or both; and
(9) Other limited benefit policies.