Maine Code § 24-2332-J

Coverage for contraceptives
Open in Lexace · Ask the AI about this section
1. Coverage requirements. All individual and group nonprofit hospital and medical services plan
policies and contracts and all nonprofit health care plan policies and contracts that provide coverage for
prescription drugs or outpatient medical services must provide coverage for all prescription
contraceptives, nonprescription oral hormonal contraceptives and nonprescription emergency
contraceptives approved by the federal Food and Drug Administration or for outpatient contraceptive
services in accordance with the requirements of this section. For purposes of this section, "outpatient
contraceptive services" means consultations, examinations, procedures and medical services provided
on an outpatient basis and related to the use of contraceptive methods to prevent an unintended
pregnancy. This section may not be construed to apply to prescription drugs or devices that are
designed to terminate a pregnancy.
[PL 2025, c. 445, §1 (AMD); PL 2025, c. 445, §14 (AFF).]
2. Exclusion for religious employer. A religious employer may request and a nonprofit hospital
or medical service organization or nonprofit health care service organization shall grant an exclusion
under the policy or contract for the coverage required by this section if the required coverage conflicts
with the religious employer's bona fide religious beliefs and practices. A religious employer that
obtains an exclusion under this subsection shall provide prospective insureds and those individuals
insured under its policy written notice of the exclusion. This section may not be construed as
authorizing a nonprofit hospital or medical service organization or nonprofit health care service
organization to exclude coverage for prescription drugs prescribed for reasons other than contraceptive
purposes or for prescription contraception that is necessary to preserve the life or health of a covered
person. For the purposes of this section, "religious employer" means an employer that is a church,
convention or association of churches or an elementary or secondary school that is controlled, operated
or principally supported by a church or by a convention or association of churches as defined in 26
United States Code, Section 3121 (w) (3) (A) and that qualifies as a tax-exempt organization under 26
United States Code, Section 501(c) (3).
[PL 1999, c. 341, §1 (NEW); PL 1999, c. 341, §5 (AFF).]

3. Application. The requirements of this section apply to all policies, contracts and certificates
executed, delivered, issued for delivery, continued or renewed in this State. For purposes of this section,
all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date.
[PL 2003, c. 517, Pt. B, §7 (NEW).]
4. Coverage of contraceptive supplies. Coverage required under this section must include
coverage for contraceptive supplies in accordance with the following requirements. For purposes of
this section, "contraceptive supplies" means all contraceptive drugs, devices and products approved by
the federal Food and Drug Administration to prevent an unwanted pregnancy, including
nonprescription oral hormonal contraceptives and nonprescription emergency contraceptives.
A. Coverage must be provided without any deductible, coinsurance, copayment or other cost-
sharing requirement. [PL 2021, c. 609, §1 (NEW); PL 2021, c. 609, §5 (AFF).]
B. If the federal Food and Drug Administration has approved one or more therapeutic equivalents
of a contraceptive supply, an insurer is not required to cover all those therapeutically equivalent
versions in accordance with this subsection, as long as at least one is covered without any
deductible, coinsurance, copayment or other cost-sharing requirement in accordance with this
subsection. [PL 2021, c. 609, §1 (NEW); PL 2021, c. 609, §5 (AFF).]
C. Coverage must be provided for the furnishing or dispensing of prescribed contraceptive supplies
and nonprescription oral hormonal contraceptive supplies intended to last for a 12-month period,
which may be furnished or dispensed all at once or over the course of the 12 months at the discretion
of the health care provider for prescribed contraceptive supplies. [PL 2025, c. 445, §2 (AMD);
PL 2025, c. 445, §14 (AFF).]
D. A prescription is not required to obtain a nonprescription oral hormonal contraceptive or
nonprescription emergency contraceptive. [PL 2025, c. 445, §2 (NEW); PL 2025, c. 445, §14
(AFF).]
E. A nonprofit hospital or medical service organization or nonprofit health care service
organization shall establish mechanisms to ensure that an enrollee who seeks coverage for a
nonprescription oral hormonal contraceptive or nonprescription emergency contraceptive at a
pharmacy has the option to obtain the nonprescription oral hormonal contraceptive or
nonprescription emergency contraceptive at the point of sale without payment of any cost-sharing
amount or to make the purchase at the pharmacy counter through an out-of-pocket payment at the
point of sale and submit a claim for reimbursement. [PL 2025, c. 445, §2 (NEW); PL 2025, c.
445, §14 (AFF).]
F. The superintendent shall monitor compliance with the requirements for coverage of
nonprescription oral hormonal contraceptives and nonprescription emergency contraceptives and
any rules adopted in accordance with subsection 5, including any complaints or barriers to
implementation. [PL 2025, c. 445, §2 (NEW); PL 2025, c. 445, §14 (AFF).]
[PL 2025, c. 445, §2 (AMD); PL 2025, c. 445, §14 (AFF).]
5. Rules. The superintendent may adopt rules as necessary to implement the requirements of this
section, including rules related to mechanisms to ensure coverage for nonprescription oral hormonal
contraceptives and nonprescription emergency contraceptives and rules regarding notice to enrollees
about how to access coverage for nonprescription oral hormonal contraceptives and nonprescription
emergency contraceptives. Rules adopted pursuant to this subsection are routine technical rules as
described in Title 5, chapter 375, subchapter 2-A.
[PL 2025, c. 445, §3 (NEW); PL 2025, c. 445, §14 (AFF).]
REVISOR'S NOTE: §2332-J. Coverage for services of certified nurse practitioners; certified nurse
midwives (As enacted by PL 1999, c. 396, §1 and affected by §7 is REALLOCATED TO TITLE 24,
SECTION 2332-K)

REVISOR'S NOTE: §2332-J. Coverage for services provided by registered nurse first assistants (As
enacted by PL 1999, c. 412, §1 is REALLOCATED TO TITLE 24, SECTION 2332-L)

‹ Prev All Maine sections Next ›


Lexace provides legal information, not legal advice, and no attorney–client relationship is created. Statute text is provided for general information and may not reflect the most recent amendments; verify against the official state code.