Introduced by Senator Shepard of Bennington District
Subject: Health; insurance; well child checkups; scheduling
Statement of purpose: This bill proposes to require health insurers to cover well child checkups consistent with a statutorily defined schedule of visits.
AN ACT RELATING TO WELL CHILD CHECKUPS
It is hereby enacted by the General Assembly of the State of Vermont:
§ 4088d. WELL CHILD CHECKUPS
(a) A health benefit plan shall provide coverage for well child checkups consistent with the following schedule of covered visits:
(1) within the first week of life;
(2) on or within two weeks of the child turning 1, 2, 4, 6, 9, 12, 15, 18, and 24 months; and
(3) thereafter, one well child checkup per year until the age of 18, provided at least 11 months have passed since the last well child checkup.
(b) As used in this section:
(1) “Health benefit plan” means any health insurance policy or health benefit plan offered by a health insurer as defined in subdivision 9402(9) of Title 18.
(2) “Well child checkup” means a regularly scheduled visit to a doctor or nurse practitioner for a child under the age of 18 who is healthy at the time of the visit. The visit may be for the purposes of performing a complete physical, assessing growth development, checking vision and hearing, providing a nutritional assessment, performing immunizations, or performing age-appropriate developmental screenings or scheduled laboratory procedures, including a lead screening.
(c) The Vermont agency of human services through its Vermont Medicaid program shall participate in the provisions of this section in the same manner as insurers as defined in subdivision 9402(9) of Title 18.
(d) The requirements of this section shall apply to all insurance policies and subscriber contracts delivered or issued for delivery on or after September 1, 2005.
The Vermont General Assembly
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