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1997 SESSION

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HB 1233 Health insurance; coverage for contraceptives.

Introduced by: Julia A. Connally | all patrons    ...    notes | add to my profiles

SUMMARY:

Accident and sickness insurance; denial of benefits for prescription contraceptives prohibited. Requires any (i) individual or group accident and sickness insurance policies providing hospital, medical and surgical or major medical coverage on an expense incurred basis; (ii) corporation providing individual or group accident and sickness subscription contracts; and (iii) health maintenance organization providing a health care plan for health care services, whose policy, contract or plan, including any certificate or evidence of coverage issued in connection with such policy, contract or plan, includes coverage for prescription drugs on an outpatient basis, to provide in each such policy, contract, plan, certificate, and evidence of coverage that such benefits will not be denied for any drug approved by the United States Food and Drug Administration for use as a contraceptive. Each such policy, contract, plan, certificate, and evidence of coverage must also include coverage for a variety of federal Food and Drug Administration approved prescription contraceptives. If the patient's physician determines that none of the methods designated by the policy, contract, plan, certificate, or evidence of coverage is medically appropriate for the patient, the plan must also provide coverage for another medically approved prescription contraceptive method prescribed by the patient's physician.

This new section will not require coverage for experimental contraceptive drugs not approved by the United States Food and Drug Administration or coverage for prescription drugs in any contract, policy or plan that does not otherwise provide such coverage. These provisions will not apply to short-term travel, or accident-only policies, or to short-term nonrenewable policies of not more than six months' duration.

This provision would apply to individual or group accident and sickness insurance policies, contracts, plans, certificates, and evidences of coverage providing outpatient prescription drugs, pursuant to 38.2-4214 and 38.2-4319, on and after July 1, 1996.


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