Bill > A02449

This bill requires health insurance policies in New York to provide coverage for infant and baby formulas under specific medical circumstances. The bill amends existing insurance law to mandate that prescription drug coverage include enteral, infant, and baby formulas for home use 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, multiple severe food allergies, eosinophilic disorders, and other conditions that impair nutrient absorption. The bill specifies that these medically necessary formulas must be distinguished from elective nutritional supplements and introduces a minimum coverage requirement of three thousand dollars per calendar year or twelve-month period for any insured individual. The coverage applies to formulas administered orally or through tube feeding and includes modified solid food products for certain inherited metabolic and protein-related conditions. The bill will take effect on the first day of January following its passage and will apply to all insurance policies issued, renewed, modified, altered, or amended after that date, ensuring broader access to medically necessary infant and baby formulas for families with specific health needs.

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https://www.nysenate.gov/legislation/bills/2025/A2449