The Vermont Statutes Online

Title 8: Banking and Insurance

Chapter 107: HEALTH INSURANCE

Sub-Chapter 001: Generally

8 V.S.A. § 4089e. Treatment of inherited metabolic diseases



§ 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 twelve months for any insured individual. (Added 1997, No. 128 (Adj. Sess.), § 1, eff. April 27, 1998)