TITLE 41

INSURANCE

CHAPTER 18

THE INSURANCE CONTRACT

41-1853.  plans covering contraception. (1) As used in this section:

(a)  "Health benefit plan" shall have the same meaning as provided in section 41-5501, Idaho Code.

(b)  "Prescription contraception" means all drugs, devices, and products approved by the United States food and drug administration that are used to prevent pregnancy and that are prescribed by an enrollee’s provider. The term "prescription contraception" does not include drugs, devices, or products intended to induce abortion as defined by section 18-604, Idaho Code.

(2)  A health benefit plan or student health benefit plan issued or renewed on or after January 1, 2025, that includes coverage for prescription contraception must:

(a)  Provide reimbursement for prescription contraception intended to last six (6) months obtained at one (1) time by the enrollee, unless:

(i)   No prescription contraception has previously been prescribed to the enrollee, in which case the prescribing provider shall prescribe a smaller supply; or

(ii)  The enrollee requests a smaller supply or the prescribing provider instructs that the enrollee must receive a smaller supply; and

(b)  Allow enrollees to receive prescription contraception on-site at the prescribing provider’s office, if available. Any dispensing practices required by the plan must follow clinical guidelines for appropriate prescribing and dispensing to ensure the health of the patient while maximizing access to effective prescription contraception.

(3)  Nothing in this section shall be construed to require a health benefit plan or a student health benefit plan to provide reimbursement for drugs, devices, or products intended to induce abortion as defined in section 18-604, Idaho Code, or for any emergency contraception approved by the United States food and drug administration.

History:

[41-1853, added 2024, ch. 53, sec. 1, p. 267.]