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Insurance Coverage for Contraception

Maryland law requires health-insurance plans that cover prescription medication to provide equitable coverage for contraception.

What is required?  If a health-insurance plan provides coverage for prescription medication, it must provide coverage for any Food and Drug-Administration-approved prescription contraception and any medically necessary exam associated with the use of contraception.

To which insurance plans does the law apply?  Insurance plans, nonprofit health service plans, and health maintenance organization (HMO) contracts that provide coverage for prescription medication.

Does the law provide additional protections for women?  Yes.  Insurers may not impose a different copayment or coinsurance for contraceptives than that imposed on any other prescription medication.

Does the law contain a refusal clause, allowing certain employers and/or insurers to refuse to provide or pay for contraceptive coverage?  Yes.

To whom does the refusal clause apply?  Religious employers for whom contraceptive coverage conflicts with their bona fide religious beliefs and practices.

What does the refusal clause allow?  A religious employer may require issuers of its health-insurance plans exclude coverage for contraception.

Is this refusal clause overbroad, jeopardizing insurance coverage for contraception for women?  Yes.  By failing to define the term "religious employer," the law's refusal clause inappropriately includes a wide range of entities that perform non-religious functions in the public sphere.

Does the law require the refusing entity to notify the persons affected?  Yes.  An employer exercising a refusal clause must provide employees reasonable and timely notice of the exclusion.

Are there circumstances under which a refusal clause may not be exercised?  No.

Does the law provide a mechanism for women to obtain contraceptive coverage if their employer exercises a refusal clause?  No.

MD. Code Ann., Ins. § 15-826 (Enacted 1998).

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