38.2-3407.5:1 - Coverage for prescription contraceptives
§ 38.2-3407.5:1. Coverage for prescription contraceptives.
A. Each (i) insurer proposing to issue individual or group accident andsickness insurance policies providing hospital, medical and surgical or majormedical coverage on an expense incurred basis; (ii) corporation providingindividual or group accident and sickness subscription contracts; and (iii)health maintenance organization providing a health care plan for health careservices, whose policy, contract or plan, including any certificate orevidence of coverage issued in connection with such policy, contract or plan,includes coverage for prescription drugs on an outpatient basis, shall offerand make available coverage thereunder for any prescribed drug or deviceapproved by the United States Food and Drug Administration for use as acontraceptive.
B. No insurer, corporation or health maintenance organization shall imposeupon any person receiving prescription contraceptive benefits pursuant tothis section any (i) copayment, coinsurance payment or fee that is notequally imposed upon all individuals in the same benefit category, class,coinsurance level or copayment level receiving benefits for prescriptiondrugs, or (ii) reduction in allowable reimbursement for prescription drugbenefits.
C. The provisions of subsection A shall not be construed to:
1. Require coverage for prescription coverage benefits in any contract,policy or plan that does not otherwise provide coverage for prescriptiondrugs;
2. Preclude the use of closed formularies, provided, however, that suchformularies shall include oral, implant and injectable contraceptive drugs,intrauterine devices and prescription barrier methods; or
3. Require coverage for experimental contraceptive drugs not approved by theUnited States Food and Drug Administration.
D. The provisions of this section shall not apply to short-term travel,accident-only, limited or specified disease policies, or contracts designedfor issuance to persons eligible for coverage under Title XVIII of the SocialSecurity Act, known as Medicare, or any other similar coverage under state orfederal governmental plans, or to short-term nonrenewable policies of notmore than six months' duration.
E. The provisions of this section shall be applicable to contracts, policiesor plans delivered, issued for delivery or renewed in this Commonwealth onand after July 1, 1997.
(1997, c. 748.)