Bill > HB1182

This bill mandates that health insurance carriers in Virginia must provide coverage for contraceptive drugs and devices, including those available over-the-counter, under any health insurance plan that covers prescription drugs on an outpatient basis. The bill defines "contraceptive device" as any FDA-approved device or non-drug product for contraception, and "contraceptive drug" as any FDA-approved drug for contraception, with "FDA" referring to the U.S. Food and Drug Administration. It prohibits insurance carriers from imposing copayments, coinsurance, or fees on individuals receiving contraceptive benefits, except in specific circumstances where different versions of a contraceptive exist and at least one is available without cost-sharing, or if a healthcare provider determines a medical need for a specific contraceptive. Furthermore, carriers cannot place burdensome restrictions or delays on coverage, such as requiring a prescription for over-the-counter contraceptives or making formal requests beyond a standard pharmacy claim, and must provide clear information about contraceptive coverage on their websites and by mail. The bill also clarifies that it does not require coverage for plans that don't already cover prescription drugs, nor does it mandate coverage for experimental contraceptives not approved by the FDA. Additionally, it requires coverage for up to a 12-month supply of hormonal contraceptives dispensed at once and provides point-of-sale coverage without cost-sharing for over-the-counter hormonal contraceptives at in-network pharmacies, with these provisions taking effect for policies delivered, issued for delivery, or renewed on or after January 1, 2027.

Budget and Finance, Business and Industry

https://lis.virginia.gov/bill-details/20261/HB1182