1. A policy of group health insurance must provide coverage for:
(a) Enteral formulas for use at home that are prescribed or ordered by a physician
as medically necessary for the treatment of inherited metabolic diseases characterized
by deficient metabolism, or malabsorption originating from congenital defects or defects
arising shortly after birth, of amino acid, organic acid, carbohydrate or fat; and
(b) At least $2,500 per year for special food products which are prescribed or ordered
by a physician as medically necessary for the treatment of a person described in paragraph
2. The coverage required by subsection 1 must be provided whether or not the condition
existed when the policy was purchased.
3. A policy subject to the provisions of this chapter that is delivered, issued for
delivery or renewed on or after January 1, 1998, has the legal effect of including
the coverage required by this section, and any provision of the policy or the renewal
which is in conflict with this section is void.
4. As used in this section:
(a) “Inherited metabolic disease” means a disease caused by an inherited abnormality
of the body chemistry of a person.
(b) “Special food product” means a food product that is specially formulated to have
less than one gram of protein per serving and is intended to be consumed under the
direction of a physician for the dietary treatment of an inherited metabolic disease.
The term does not include a food that is naturally low in protein.
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