Bill > S00868

This bill requires certain health insurance policies to expand coverage for infant and baby formulas by mandating that health insurers include coverage for these formulas under specific medical conditions. The bill amends existing insurance law to require coverage for infant and baby formulas when a physician provides a written order stating the formula is medically necessary for treating specific health conditions. These conditions include inherited metabolic diseases, Crohn's Disease, gastroesophageal reflux, severe food allergies, and other disorders that affect nutrient absorption or could cause chronic disability. The bill stipulates that coverage must be at least $3,000 per calendar year or twelve-month period for each insured individual, and distinguishes medically necessary formulas from elective nutritional supplements. The coverage applies to formulas administered orally or via tube feeding and requires a detailed medical justification from a licensed healthcare provider. The bill will take effect on the first day of January following its passage and will apply to all health insurance policies issued, renewed, or modified after that date, ensuring broader access to specialized infant and baby formulas for families with specific medical needs.

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https://www.nysenate.gov/legislation/bills/2025/S868