Contraceptive Equity

Vermont law requires health insurance plans that cover prescription drugs to provide equitable coverage for contraception.

What is required?  If a health insurance plan provides coverage for prescription drugs, it must provide coverage for all Food and Drug Administration-approved prescription contraceptive drugs and devices.  In addition, health insurance plans must cover outpatient contraceptive services.

To which insurance plans does the law apply?  Individual and group health insurance plans, hospital or medical service corporation contracts, and health maintenance organization (HMO) contracts, except certain limited benefit plans, that provide coverage for prescription drugs.

Does the law provide additional protections for women?  Yes.  Such plans may not impose any financial burden for coverage of contraceptive drugs, devices, or services greater than those imposed for other treatments, prescriptions, or devices.

Does the law contain a refusal clause, allowing certain employers and/or insurers to refuse to provide or pay for contraceptive coverage?  No.

Vt . Stat. Ann. tit. 8, § 4099c (Enacted 1999).

Emergency Contraception

PHARMACY ACCESS TO EMERGENCY CONTRACEPTION (EC)

Vermont explicitly allows pharmacists to provide emergency contraception (EC) directly to women without a prescription.  A pharmacist may dispense EC under a collaborative agreement with a physician or other authorized prescriber.  The agreement must be consistent with the standard protocol and procedures developed by the Department of Health in conjunction with the Board of Pharmacy, and include an informed consent form, information for the EC recipient and pharmacist, and necessary forms.

A pharmacist must provide all EC recipients with a standardized fact sheet that includes the indications for use of EC, the appropriate method for using EC, information on the importance of follow-up health care, health care referral information, information on sexual assault, information on the risks of unprotected sexual intercourse, referral to appropriate agencies, and other appropriate information.

All pharmacists dispensing EC must first complete an education and training program delivered by an entity authorized by a national council on pharmaceutical education or another training program approved by the Board of Pharmacy.

Vt. Stat. Ann. tit. 26, §§ 2077 to 2079 (Enacted 2006).

Low-Income Women's Access to Abortion

Vermont allows women eligible for state medical assistance for general health care to obtain public funds for medically necessary abortions.  Vt. Dep't of Soc. Welfare, PP & D Memo, Policy Interpretation (Jan. 12, 1994); Vt. Dep't of Soc. Welfare, Abortion Certification, DSW 219B (Rev. March 1998) at http://www.vtmedicaid.com/Downloads/forms/Abortion%20forms%20219AB.pdf; Doe v. Celani, No. S81-84CnC (Vt. Super. Ct. May, 26, 1986) (invalidating an earlier state regulation as unconstitutional and unenforceable under the Vermont Constitution to the extent that the regulation funded only procedures covered by the federal Medicaid program and did not fund all medically necessary abortions).

State Constitutional Protection

The Vermont Constitution protects the right to reproductive choice to a greater extent than the federal Constitution. A regulation limiting state medical assistance for abortion to those procedures covered by the federal Medicaid program was struck down under the state constitution because the provision excluded medically necessary abortions and only allowed reimbursement for abortions in cases of life endangerment. Doe v. Celani, No. S81-84CnC (Vt. Super. Ct. May 26, 1986). A similar restriction has been upheld by the U.S. Supreme Court under the federal Constitution. Williams v. Zbaraz, 448 U.S. 358 (1980).