Maine - State Diabetes Insurance Coverage Laws
Maine - State Diabetes Insurance Coverage Laws
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Maine has state-mandated laws that require individual and group insurance carriers (including HMOs) to cover diabetes care and education services.
Tit 24 § 2332-F (nonprofits); 2654 (individual) and 2847-E (group) - 1996 law. Covers medically appropriate and necessary equipment, insulin, oral hypoglycemic agents, monitors, test strips, syringes and lancets, and out-patient self-management.
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? Yes
Reimbursement of Diabetes Self-Management Education and Supplies in Maine
According to the state of Main government website:
Public Law 592 (P.L. 592):
Effective July 4, 1996, Maine law P.L. 592 requires that health insurance policies in the state cover the following:
Supplies
Insulin
Oral hypoglycemic agents
Blood glucose monitors
Test strips, lancets, and syringes
Diabetes Self-Management Training and Education
The Ambulatory Diabetes Education & Follow-Up (ADEF) Diabetes Self-Management Training (DSMT) Program authorized by the state’s Diabetes Prevention & Control Program (DPCP) within DHHS’s Maine Centers for Disease Control and Prevention. Some exceptions apply (ie. self-insured businesses)
Supplies and Self-Management Training and Education must be certified necessary by your doctor. This law does not change current Medicare and Maine Care Program coverage. Call 1 (800) 273-7147 or 287-5380 for more information.
Maine Diabetes Control Project - The program includes diabetes surveillance and evaluation activities; professional education; community interventions; technical assistance and resource support; promotion and advocacy of diabetes management standards of care; and, health insurance coverage for appropriate diabetes medical care, diabetic supplies and education.
Main Insurance Bulletin 258: Mandate — Diabetes (Ch. 592) (07/04/96) - All individual and group policies (including HMO's), except accident only, specified disease, or hospital indemnity policies must provide coverage for the treatment of diabetes, including equipment, supplies and education. Education must be through ambulatory diabetes facilities authorized by the Diabetes Control Project.
Maine Diabetes Prevention and Control Program
