Tex. Ins. Code § 1358.054

Current with legislation from the 2023 Regular and Special Sessions signed by the Governor as of November 21, 2023.

Section 1358.054 - Coverage Required

(a) A health benefit plan that provides coverage for the treatment of diabetes and conditions associated with diabetes must provide to each qualified enrollee coverage for:

(1) diabetes equipment;

(2) diabetes supplies; and

(3) diabetes self-management training in accordance with the requirements of Section 1358.055.

(a-1) A health benefit plan described by Subsection (a) must provide to each qualified enrollee coverage for emergency refills of diabetes equipment or diabetes supplies dispensed to the enrollee in accordance with Section 562.0541, Occupations Code, in the same manner as for a nonemergency refill of diabetes equipment or diabetes supplies.

(b) A health benefit plan may require a deductible, copayment, or coinsurance for coverage provided under this section. The amount of the deductible, copayment, or coinsurance may not exceed the amount of the deductible, copayment, or coinsurance required for treatment of other analogous chronic medical conditions.

Tex. Ins. Code § 1358.054

Amended by Acts 2021, Texas Acts of the 87th Leg. - Regular Session, ch. 679,Sec. 2, eff. 9/1/2021, op. applies only to a health benefit plan that is delivered, issued for delivery, or renewed on or after January 1, 2022.

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. 4/1/2005.