An Act providing for certain health insurance coverage
This bill requires all health insurance plans in Massachusetts - including those covering state employees, group plans, and individual policies - to cover the cost of specialized medical formulas (for home use, administered orally or via tube feeding) when prescribed by a doctor for specific serious conditions. It applies to policies governed by Massachusetts law, including group insurance, hospital service plans, and medical service agreements. Coverage is limited to formulas proven effective for conditions like inherited metabolic disorders, Crohn's disease, or severe food allergies, as documented by a physician's written order stating medical necessity. The bill explicitly distinguishes these medically required formulas from general nutritional supplements taken without a medical need.
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