Bill > S572

This bill aims to improve access to fertility medications for individuals with health insurance in North Carolina by requiring insurers that offer fertility treatment coverage to treat ovulation medications similarly to other prescription medications. Specifically, the bill prohibits insurers from imposing different annual or lifetime limitations on ovulation medications compared to other prescription drugs when fertility treatment is already covered in a health plan. The bill defines key terms like "fertility treatment" (using guidelines from the American Society of Reproductive Medicine) and clarifies that while insurers must apply consistent medication coverage rules, they are not mandated to provide fertility treatment coverage in the first place. Additionally, the bill requires the North Carolina State Health Plan for Teachers and State Employees to remove annual and lifetime limitations on ovulation medication and ovulation induction cycles for in-network services starting January 1, 2026. The bill allocates $300,000 in fiscal year 2025-2026 and $600,000 in fiscal year 2026-2027 to cover the increased costs to the State Health Plan, with the overall provisions becoming effective on October 1, 2025, and applying to insurance contracts issued or renewed after that date.

https://www.ncleg.gov/BillLookUp/2025/S572