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<law><site_title>Virginia Decoded</site_title><site_url>https://vacode.org</site_url><law_id>54072</law_id><section_number>38.2-3407.5:1</section_number><catch_line>Coverage for prescription contraceptives</catch_line><edition url="https://vacode.org/2025/" slug="2025" current="TRUE" last_updated="">2025</edition><structure><unit label="title" level="1" order_by="1" identifier="38.2">Insurance</unit><unit label="chapter" level="2" order_by="1" identifier="34">Provisions Relating to Accident and Sickness Insurance</unit><unit label="article" level="3" order_by="1" identifier="1">General Provisions</unit></structure><text>
						<section id="A"><p><span class="prefix-number">A.</span> Each (i) <span class="dictionary">insurer</span> proposing to <span class="dictionary">issue</span> individual or group accident and sickness <span class="dictionary">insurance policies</span> providing hospital, medical and surgical or major medical coverage on an expense incurred basis; (ii) corporation providing individual or group accident and sickness subscription <span class="dictionary">contracts</span>; and (iii) health maintenance organization providing a health care plan for health care services, whose policy, <span class="dictionary">contract</span> or plan, including any certificate or <span class="dictionary">evidence</span> of coverage issued in connection with such policy, <span class="dictionary">contract</span> or plan, includes coverage for prescription drugs on an outpatient basis, shall offer and make available coverage thereunder for any prescribed drug or device approved by the United <span class="dictionary">States</span> Food and Drug Administration for use as a contraceptive. <a id="paragraph-198494" class="section-permalink" href="https://vacode.org/38.2-3407.5_1/#A"><i class="fa fa-link"/></a></p></section>
						<section id="B"><p><span class="prefix-number">B.</span> No <span class="dictionary">insurer</span>, corporation or health maintenance organization shall impose upon any <span class="dictionary">person</span> receiving prescription contraceptive benefits pursuant to this section any (i) copayment, coinsurance payment or fee that is not equally imposed upon all individuals in the same benefit category, class, coinsurance level or copayment level receiving benefits for prescription drugs, or (ii) reduction in allowable reimbursement for prescription drug benefits. <a id="paragraph-198495" class="section-permalink" href="https://vacode.org/38.2-3407.5_1/#B"><i class="fa fa-link"/></a></p></section>
						<section id="C"><p><span class="prefix-number">C.</span> The provisions of subsection A shall not be construed to: <a id="paragraph-198496" class="section-permalink" href="https://vacode.org/38.2-3407.5_1/#C"><i class="fa fa-link"/></a></p></section>
						<section id="C1" class="indent-1"><p><span class="prefix-number">1.</span> Require coverage for prescription coverage benefits in any <span class="dictionary">contract</span>, policy or plan that does not otherwise provide coverage for prescription drugs; <a id="paragraph-198497" class="section-permalink" href="https://vacode.org/38.2-3407.5_1/#C1"><i class="fa fa-link"/></a></p></section>
						<section id="C2" class="indent-1"><p><span class="prefix-number">2.</span> Preclude the use of closed formularies, provided, however, that such formularies shall include oral, implant and injectable contraceptive drugs, intrauterine devices and prescription barrier methods; or <a id="paragraph-198498" class="section-permalink" href="https://vacode.org/38.2-3407.5_1/#C2"><i class="fa fa-link"/></a></p></section>
						<section id="C3" class="indent-1"><p><span class="prefix-number">3.</span> Require coverage for experimental contraceptive drugs not approved by the United <span class="dictionary">States</span> Food and Drug Administration. <a id="paragraph-198499" class="section-permalink" href="https://vacode.org/38.2-3407.5_1/#C3"><i class="fa fa-link"/></a></p></section>
						<section id="D"><p><span class="prefix-number">D.</span> The provisions of this section shall not apply to short-term travel, accident-only, limited or specified disease policies, or <span class="dictionary">contracts</span> designed for issuance to <span class="dictionary">persons</span> eligible for coverage under Title XVIII of the Social Security Act, known as <span class="dictionary">Medicare</span>, or any other similar coverage under <span class="dictionary">state</span> or federal governmental plans, or to short-term nonrenewable policies of not more than six months&#x2019; duration. <a id="paragraph-198500" class="section-permalink" href="https://vacode.org/38.2-3407.5_1/#D"><i class="fa fa-link"/></a></p></section>
						<section id="E"><p><span class="prefix-number">E.</span> The provisions of this section shall be applicable to <span class="dictionary">contracts</span>, policies or plans delivered, issued for delivery or renewed in this Commonwealth on and after July 1, 1997. <a id="paragraph-198501" class="section-permalink" href="https://vacode.org/38.2-3407.5_1/#E"><i class="fa fa-link"/></a></p></section></text><history>1997, c. 748.</history><metadata></metadata></law>
