§ 4089e. Treatment of inherited metabolic diseases
(a) For the purposes of this section:
(1) “Inherited metabolic disease” means a disease caused by an inherited abnormality of body chemistry for which the State screens newborn infants.
(2) “Insurer” means any health insurance company, nonprofit hospital and medical service corporation, managed care organization, and health maintenance organization. The term does not apply to coverage for specified disease or other limited benefit coverage.
(3) “Low protein modified food product” means a food product that is specifically formulated to have less than one gram of protein per serving and is intended to be used under the direction of a physician for the dietary treatment of a metabolic disease.
(4) “Medical food” means an amino acid modified preparation that is intended to be used under the direction of a physician for the dietary treatment of an inherited metabolic disease.
(b) An insurer shall provide coverage for medical foods prescribed for medically necessary treatment for an inherited metabolic disease.
(c) Coverage for low protein modified food products prescribed for medically necessary treatment of an inherited metabolic disease shall be at least $2,500.00 during any continuous period of 12 months for any insured individual. (Added 1997, No. 128 (Adj. Sess.), § 1, eff. April 27, 1998.)
Structure Vermont Statutes
Title 8 - Banking and Insurance
Chapter 107 - Health Insurance
§ 4062. Filing and approval of policy forms and premiums
§ 4062b. Medicare supplemental health insurance
§ 4062c. Compliance with federal law
§ 4062e. Compliance with Medicaid recovery provisions
§ 4062f. Discretionary clauses prohibited
§ 4063. Form and contents of policy
§ 4063a. Coverage for civil unions
§ 4063b. Coverage for employees of an employer domiciled outside Vermont
§ 4064. Provisions applying to policies delivered in another state
§ 4065. Required standard policy provisions
§ 4066. Optional standard policy provisions
§ 4067. Omission of inapplicable or inconsistent standard provisions
§ 4068. Order of standard policy provisions
§ 4070. Requirements of other jurisdictions
§ 4071. Regulations on filing policies
§ 4072. Nonconforming policies
§ 4073. Applications for insurance
§ 4077. Termination; comprehensive major medical policies; grace period
§ 4079. Group insurance policies; definitions
§ 4079a. Association health plans
§ 4080. Required policy provisions
§ 4080d. Coordination of insurance coverage with Medicaid
§ 4080e. Medicare supplemental health insurance policies; community rating; disability
§ 4081. Blanket health insurance
§ 4082. Blanket insurance; policy contents
§ 4083. Discrimination prohibited
§ 4084a. Short-term, limited-duration health insurance
§ 4085a. Rebates prohibited for group insurance policies
§ 4086. Exemption from attachment and trustee process
§ 4087. Penalties for violations
§ 4088a. Chiropractic services
§ 4088b. Clinical trials for cancer patients
§ 4088c. Chemotherapy treatment
§ 4088d. Coverage for covered services provided by naturopathic physicians
§ 4088e. Notice of preferred drug list changes
§ 4088g. Coverage for covered services provided by athletic trainers
§ 4088h. Health insurance and the Blueprint for Health
§ 4088i. Coverage for diagnosis and treatment of early childhood developmental disorders
§ 4088j. Choice of providers for vision care and medical eye care services
§ 4088k. Physical therapy co-payments for certain plans
§ 4088l. Coverage for hearing aids [Effective January 1, 2024]
§ 4089. Services for victims of sexual assault
§ 4089a. Mental health care services review
§ 4089b. Health insurance coverage, mental health, and substance use disorder
§ 4089d. Coverage; dependent children
§ 4089e. Treatment of inherited metabolic diseases
§ 4089f. Independent external review of health care service decisions
§ 4089g. Craniofacial disorders
§ 4089h. Cancellation or nonrenewal of health insurance coverage
§ 4089i. Prescription drug coverage
§ 4089j. Retail pharmacies; filling of prescriptions
§ 4090a. Continuation of group
§ 4090b. Continuation; notice; terms
§ 4090c. Termination of coverage
§ 4090e. Conversion; notice; terms
§ 4090f. Exemptions; termination
§ 4091b. Policies and contracts covered
§ 4091c. Termination for nonpayment of premium or subscription charges
§ 4091d. Notice of termination
§ 4091e. Extension of benefits
§ 4092. Newborn infants; coverage
§ 4096. Home health care; insurance
§ 4099c. Reproductive health equity in health insurance coverage
§ 4099d. Midwifery coverage; home births
§ 4100a. Mammograms; coverage required
§ 4100c. Adopted child coverage
§ 4100d. Child vaccine benefits
§ 4100e. Required coverage for off-label use
§ 4100f. Prostate screenings; coverage required
§ 4100g. Colorectal cancer screening, coverage required
§ 4100h. Orally administered anticancer medication; coverage required
§ 4100i. Anesthesia coverage for certain dental procedures
§ 4100j. Coverage for tobacco cessation programs
§ 4100l. Coverage of health care services delivered by audio-only telephone