Accessible Care Act - aka Obamacare
Right. Thanks, so used to Obamacare.
I’m not a lawyer but most states have laws mandating that insurance policies cover diabetes.
In NC it is stated:
§ 58-51-61. Coverage for certain treatment for diabetes.
(a) Every policy or contract of accident or health insurance, and every preferred provider benefit plan under G.S. 58-50-56, that is issued, renewed, or amended on or after October 1, 1997, shall provide coverage for medically appropriate and necessary services, including diabetes outpatient self-management training and educational services, and equipment, supplies, medications, and laboratory procedures used to treat diabetes. Diabetes outpatient self-management training and educational services shall be provided by a physician or a health care professional designated by the physician. The insurer shall determine who shall provide and be reimbursed for the diabetes outpatient self-management training and educational services. The same deductibles, coinsurance, and other limitations as apply to similar services covered under the policy, contract, or plan shall apply to the diabetes coverage required under this section.
(b) For the purposes of this section, “physician” is a person licensed to practice in this State under Article 1 or Article 7 of Chapter 90 of the General Statutes. (1997-225, s. 1; 1997-519, s. 3.11.)
So if you appeal your insurance company’s decision to short you almost half a year’s worth if medication essential to the treatment of your diabetes, I would suggest you get documentation from your physician stating that insulin is “medically appropriate and necessary” for the treatment of your diabetes. What BCBS is doing doesn’t seem legal here. It might be worth finding a legal advocate to present your case.
Again, I am not a lawyer and am not offering legal advice.