Sec. 6. (a) A health insurance plan issued by an insurer must provide coverage for diabetes self-management training that is:
(1) medically necessary;
(2) ordered in writing by a physician licensed under IC 25-22.5, a podiatrist licensed under IC 25-29, an advanced practice registered nurse licensed under IC 25-23, or a physician assistant licensed under IC 25-27.5; and
(3) provided by a health care professional who:
(A) is licensed, registered, or certified under IC 25; and
(B) has specialized training in the management of diabetes.
(b) Coverage for diabetes self-management training may be limited to the following:
(1) One (1) or more visits after receiving a diagnosis of diabetes.
(2) One (1) or more visits after receiving a diagnosis by a physician licensed under IC 25-22.5 or a podiatrist licensed under IC 25-29 that:
(A) represents a significant change in the insured's symptoms or condition; and
(B) makes changes in the insured's self-management medically necessary.
(3) One (1) or more visits for reeducation or refresher training.
(c) Coverage for diabetes self-management training is subject to the requirements of the health insurance plan regarding the use of participating providers.
As added by P.L.190-1997, SEC.1. Amended by P.L.143-2022, SEC.74.
Structure Indiana Code
Article 8. Life, Accident, and Health
Chapter 14.5. Coverage for Services Related to Diabetes
27-8-14.5-0.1. Application of Chapter
27-8-14.5-1. "Health Insurance Plan"
27-8-14.5-2. "Insured" Defined
27-8-14.5-3. "Insurer" Defined
27-8-14.5-4. Coverage for Treatments, Supplies, and Equipment
27-8-14.5-5. Deductible, Copayment, and Coinsurance Provisions