Bill > HB200

This bill requires all individual and group health insurance plans in Delaware, including the state employee health plan and Medicaid, to provide comprehensive coverage for pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) treatments designed to prevent HIV infection. PrEP is a preventive medication taken before potential HIV exposure, while PEP is a treatment taken after potential exposure. The bill mandates that these treatments be covered without any cost-sharing requirements (such as deductibles, copayments, or out-of-pocket expenses), and prohibits insurers from imposing prior authorization, step therapy requirements, or causing unreasonable delays in coverage determination. The bill defines "medically necessary" treatment as prescribing PrEP and PEP to individuals at increased risk of HIV acquisition. Some exceptions are made for specific types of limited health insurance policies, and special provisions are included to ensure that the coverage does not interfere with high-deductible health plans or health savings account eligibility. The new requirements will apply to insurance policies renewed, modified, altered, amended, or reissued after December 31, 2026, giving insurers and healthcare providers time to adapt to the new mandates.

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https://legis.delaware.gov/BillDetail?LegislationId=142639